Small hyperechoic nodules in chronic liver diseases include hepatocellular carcinomas with low cyclin D1 and Ki-67 expression
✍ Scribed by Michiko Yamagata; Tsutomu Masaki; Takahito Okudaira; Yasuo Imai; Shuichiro Shiina; Yasushi Shiratori; Masao Omata
- Book ID
- 102245791
- Publisher
- John Wiley and Sons
- Year
- 1999
- Tongue
- English
- Weight
- 395 KB
- Volume
- 29
- Category
- Article
- ISSN
- 0270-9139
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✦ Synopsis
In spite of the importance of periodic screening for hepatocellular carcinoma (HCC) by ultrasonography (US) in patients with underlying liver disease, the clinicopathological characteristics of hyperechoic nodules have not been clearly evaluated. The aim of this study was to characterize the pathological and proliferating features of small hyperechoic nodules. Tissue specimens of 55 hyperechoic and 107 hypoechoic nodules less than 20 mm in diameter in patients with chronic liver disease were obtained by echoguided needle biopsy and examined histopathologically. Of these, 42 (76%) hyperechoic and 56 (52%) hypoechoic nodules were diagnosed as HCC, and 82% of hyperechoic HCCs contained fatty change and/or clear cell change. In addition, immunohistochemical staining using cyclin D1, p53, and Ki-67 was examined. A high-level expression of cyclin D1 was found in only 5% of hyperechoic HCCs, in contrast to 38% of hypoechoic HCCs (P F .02). The labeling index of Ki-67 in hyperechoic HCCs was lower than in hypoechoic HCCs (4.2% vs. 8.9%; P F .003). However, there was no difference on p53 staining between them. Retrospective follow-up study revealed that hyperechoic nodules showed slow growth (doubling time, median: 1,403 days) initially, and came to show rapid growth (doubling time, median: 56 days). From these results, small hyperechoic nodules in chronic liver diseases are worth notice as candidates for well-differentiated HCC with low cyclin D1 and Ki-67 expression. (HEPATOLOGY 1999;30:1722-1729.) Hepatocellular carcinoma (HCC) is one of the common neoplasms in the world, especially in Asian countries, Spain, and Italy. HCC comprises 91% of primary liver cancer in Japan. 1 Prognosis of patients with small HCC was markedly improved as a result of recent advances in diagnostic procedures for detecting small lesions. 2,3 Several diagnostic procedures used for the detection of small HCC include ultrasonography (US), computed tomography (CT), magnetic resonance Abbreviations: HCC, hepatocellular carcinoma; US, ultrasonography; CT, computed tomography; MRI, magnetic resonance imaging; mAb, monoclonal antibody.