- Volume 14 Issue 1
DOI QR Code
Clinicopathologic Characteristics and Prognoses for Multicentric Occurrence and Intrahepatic Metastasis in Synchronous Multinodular Hepatocellular Carcinoma Patients
- Li, Shi-Lai (Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University) ;
- Su, Ming (Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University) ;
- Peng, Tao (Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University) ;
- Xiao, Kai-Yin (Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University) ;
- Shang, Li-Ming (Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University) ;
- Xu, Bang-Hao (Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University) ;
- Su, Zhi-Xiong (Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University) ;
- Ye, Xin-Ping (Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University) ;
- Peng, Ning (Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University) ;
- Qin, Quan-Lin (Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University) ;
- Chen, De-Feng (Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University) ;
- Chen, Jie (Department of Hepatobiliary Surgery, Tumor Hospital Affiliated of Guangxi Medical University) ;
- Li, Le-Qun (Department of Hepatobiliary Surgery, Tumor Hospital Affiliated of Guangxi Medical University)
- Published : 2013.01.31
Background: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and the outcomes for patients are still poor. It is important to determine the original type of synchronous multinodular HCC for preoperative assessment and the choice of treatment therapy as well as for the prediction of prognosis after treatment. Aims: To analyze clinicopathologic characteristics and prognoses in patients with multicentric occurrence (MO) and intrahepatic metastasis (IM) of synchronous multinodular hepatocellular carcinoma (HCC). Methods: The study group comprised 42 multinodular HCC patients with a total of 112 nodules. The control group comprised 20 HCC patients with 16 single nodular HCC cases and 4 HCC cases with a portal vein tumor emboli. The mitochondrial DNA (mtDNA) D-loop region was sequenced, and the patients of the study group were categorized as MO or IM based on the sequence variations. Univariate and multivariate analyses were used to determine the important clinicopathologic characteristics in the two groups. Results: In the study group, 20 cases were categorized as MO, and 22 as IM, whereas all 20 cases in the control group were characterized as IM. Several factors significantly differed between the IM and MO patients, including hepatitis B e antigen (HBeAg), cumulative tumor size, tumor nodule location, cirrhosis, portal vein and/or microvascular tumor embolus and the histological grade of the primary nodule. Multivariate analysis further demonstrated that cirrhosis and portal vein and/or microvascular tumor thrombus were independent factors differentiating between IM and MO patients. The tumor-free survival time of the MO subjects was significantly longer than that of the IM subjects (
Supported by : National Natural Science Foundation of China
- Sun HC, Zhang W, Qin LX, et al (2007). Positive serum hepatitis B e antigen is associated with higher risk of early recurrence and poorer survival in patients after curative resection of hepatitis B-related hepatocellular carcinoma. J Hepatol, 47, 684-90. https://doi.org/10.1016/j.jhep.2007.06.019
- Umemura T, Kiyosawa K (2007). Epidemiology of hepatocellular carcinoma in Japan. Hepatol Res, 37 Suppl 2, S95-S100. https://doi.org/10.1111/j.1872-034X.2007.00169.x
- Utsunomiya I (2005). Pathological study on multicentric occurrence of hepatocellular carcinoma. Kurume Med J, 52, 133-8. https://doi.org/10.2739/kurumemedj.52.133
- Wang J, Li Q, Sun Y, et al (2009). Clinicopathologic features between multicentric occurence and intrahepatic metastasis of multiple hepatocellular carcinomas related to HBV. Surg Oncol, 18, 25-30. https://doi.org/10.1016/j.suronc.2008.05.009
- Yamamoto T, Kajino K, Kudo M, et al (1999). Determination of the clonal origin of multiple human hepatocellular carcinomas by cloning and polymerase chain reaction of the integrated hepatitis B virus DNA. Hepatology, 29, 1446-52. https://doi.org/10.1002/hep.510290523
- Yasui M, Harada A, Nonami T, et al (1997). Potentially multicentric hepatocellular carcinoma: clinicopathologic characteristics and postoperative prognosis. World J Surg, 21, 860-5. https://doi.org/10.1007/s002689900318
- Yu M (2012). Somatic mitochondrial DNA mutations in human cancers. Adv Clin Chem, 57, 99-138. https://doi.org/10.1016/B978-0-12-394384-2.00004-8
- Zhou L, Liu C, Meng FD, et al (2012). Long-term prognosis in hepatocellular carcinoma patients after hepatectomy. Asian Pac J Cancer Prev, 13, 483-6. https://doi.org/10.7314/APJCP.2012.13.2.483
- Ikeda K, Arase Y, Kobayashi M, et al (2003). Significance of multicentric cancer recurrence after potentially curative ablation of hepatocellular carcinoma: a long term cohort study of 892 patients with viral cirrhosis. J Gastroenterol, 38, 865-76. https://doi.org/10.1007/s00535-003-1163-2
- Lestienne P (1992). Mitochondrial DNA mutations in human diseases: a review. Biochimie, 74, 123-30. https://doi.org/10.1016/0300-9084(92)90035-D
- Li Q, Wang J, Juzi JT, et al (2008). Clonality analysis for multicentric origin and intrahepatic metastasis in recurrent and primary hepatocellular carcinoma. J Gastrointest Surg, 12, 1540-7. https://doi.org/10.1007/s11605-008-0591-y
- Liver Cancer Study Group of Japan (1997). Classification of primary liver cancer. First English Ed, Kanehara Shuppan,Tokyo.
- Maeda T, Takenaka K, Taguchi K, et al (2000). Clinicopathological characteristics of surgically resected minute hepatocellular carcinomas. Hepatogastroenterology, 47, 498-503.
- Nakano S, Haratake J, Okamoto K, Takeda S (1994). Investigation of resected multinodular hepatocellular carcinoma: assessment of unicentric or multicentric genesis from histological and prognostic viewpoint. Am J Gastroenterol, 89, 189-93.
- Nomoto S, Kinoshita T, Kato K, et al (2007). Hypermethylation of multiple genes as clonal markers in multicentric hepatocellular carcinoma. Br J Cancer, 97, 1260-5. https://doi.org/10.1038/sj.bjc.6604016
- Nomoto S, Yamashita K, Koshikawa K, Nakao A, Sidransky D (2002). Mitochondrial D-loop mutations as clonal markers in multicentric hepatocellular carcinoma and plasma. Clin Cancer Res, 8, 481-7.
- Oda T, Tsuda H, Scarpa A, Sakamoto M, Hirohashi S (1992). Mutation pattern of the p53 gene as a diagnostic marker for multiple hepatocellular carcinoma. Cancer Res, 52, 3674-8.
- Okamoto M, Utsunomiya T, Wakiyama S, et al (2006). Specific gene-expression profiles of noncancerous liver tissue predict the risk for multicentric occurrence of hepatocellular carcinoma in hepatitis C virus-positive patients. Ann Surg Oncol, 13, 947-54. https://doi.org/10.1245/ASO.2006.07.018
- Parkin DM, Bray F, Ferlay J, Pisani P (2005). Global cancer statistics, 2002. CA Cancer J Clin, 55, 74-108. https://doi.org/10.3322/canjclin.55.2.74
- Perry JF, Charlton B, Koorey DJ, et al (2007). Outcome of patients with hepatocellular carcinoma referred to a tertiary centre with availability of multiple treatment options including cadaveric liver transplantation. Liver Int, 27, 1240-8.
- Poon RTP, Fan ST, Wong J (2000). Risk factors, prevention, and management of postoperative recurrence after resection of hepatocellular carcinoma. Ann Surg, 232, 10-2. https://doi.org/10.1097/00000658-200007000-00003
- Portolani N, Coniglio A, Ghidoni S, et al (2006). Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications. Ann Surg, 243, 229-35. https://doi.org/10.1097/01.sla.0000197706.21803.a1
- Shimada M, Hamatsu T, Yamashita Y, et al (2001). Characteristics of multicentric hepatocellular carcinomas: comparison with intrahepatic metastasis. World J Surg, 25, 991-5. https://doi.org/10.1007/s00268-001-0068-6
- Amuthan G, Biswas G, Zhang SY, et al (2001). Mitochondriato-nucleus stress signaling induces phenotypic changes, tumor progression and cell invasion. EMBO J, 20, 1910-20. https://doi.org/10.1093/emboj/20.8.1910
- Arii S, Yamaoka Y, Futagawa S, et al (2000). Results of surgical and nonsurgical treatment for small-sized hepatocellular carcinomas: a retrospective and nationwide survey in Japan. The Liver Cancer Study Group of Japan. Hepatology, 32, 1224-9. https://doi.org/10.1053/jhep.2000.20456
- Ariizumi S, Takasaki K, Yamamoto M, et al (2004). Histopathologic differentiation of the main nodule determines outcome after hepatic resection for synchronous multicentric hepatocellular carcinomas. Hepatogastroenterology, 51, 500-4.
- Calabrese P, Tavare S, Shibata D (2004). Pretumor progression: clonal evolution of human stem cell populations. Am J Pathol, 164,1337-46. https://doi.org/10.1016/S0002-9440(10)63220-8
- Carew JS, Huang P (2002). Mitochondrial defects in cancer. Mol Cancer, 1, 9. https://doi.org/10.1186/1476-4598-1-9
- Chen YJ, Yeh SH, Chen JT, et al (2000). Chromosomal changes and clonality relationship between primary and recurrent hepatocellular carcinoma. Gastroenterology, 119,431-40. https://doi.org/10.1053/gast.2000.9373
- Chuang WL, Chang WY, Lu SN, et al (1992). The role of hepatitis B and C viruses in hepatocellular carcinoma in a hepatitis B endemic area. A case-control study. Cancer, 69, 2052-4. https://doi.org/10.1002/1097-0142(19920415)69:8<2052::AID-CNCR2820690808>3.0.CO;2-N
- Croteau DL, Bohr VA (1997). Repair of oxidative damage to nuclear and mitochondrial DNA in mammalian cells. J Biol Chem, 272, 25409-12. https://doi.org/10.1074/jbc.272.41.25409
- Dogan E, Yalcin S, Koca D, Olmez A (2012). Clinicopathological characteristics of hepatocellular carcinoma in Turkey. Asian Pac J Cancer Prev, 13, 2985-90. https://doi.org/10.7314/APJCP.2012.13.6.2985
- Hibi K, Mitomi H, Koizumi W, et al (1997). Enhanced cellular proliferation and p53 accumulation in gastric mucosa chronically infected with Helicobacter pylori. Am J Clin Pathol, 108, 26-34.
- Huang ZY, Liang BY, Xiong M, et al (2012). Long-term outcomes of repeat hepatic resection in patients with recurrent hepatocellular carcinoma and analysis of recurrent types and their prognosis: a single-center experience in china. Ann Surg Oncol, 19, 2515-25. https://doi.org/10.1245/s10434-012-2269-7
- The risk factors of early recurrence after hepatectomy in hepatocellular carcinoma vol.86, pp.6, 2014, https://doi.org/10.4174/astr.2014.86.6.283
- Hepatitis B Virus Infection Is Associated with Poor Prognosis in Patients with Advanced Non Small Cell Lung Cancer vol.16, pp.13, 2015, https://doi.org/10.7314/APJCP.2015.16.13.5285
- A comparison of the risk factors of intrahepatic recurrence, early recurrencen, and multiple recurrences after resection for single nodular hepatocellular carcinoma vol.19, pp.3, 2015, https://doi.org/10.14701/kjhbps.2015.19.3.89
- Polymorphisms in Predicting Prognosis of Hepatocellular Carcinoma in Patients Receiving Transcatheter Arterial Chemoembolization vol.20, pp.4, 2016, https://doi.org/10.1089/gtmb.2015.0267
- Long-term outcome of laparoscopic ablation therapies for unresectable hepatocellular carcinoma: a single European center experience of 426 patients vol.30, pp.5, 2016, https://doi.org/10.1007/s00464-015-4468-3
- Effects of Different Anesthetic Methods on Cellular Immune and Neuroendocrine Functions in Patients With Hepatocellular Carcinoma Before and After Surgery vol.30, pp.6, 2016, https://doi.org/10.1002/jcla.22000
- The effectiveness of selective internal radiation therapy in challenging cases of liver-predominant unresectable hepatocellular carcinoma vol.10, pp.15s, 2014, https://doi.org/10.2217/fon.14.218
- Associations between sequence variations in the mitochondrial DNA D-loop region and outcome of hepatocellular carcinoma vol.11, pp.6, 2016, https://doi.org/10.3892/ol.2016.4466
- Recurrence Patterns After Anatomic or Parenchyma-Sparing Liver Resection for Hepatocarcinoma in a Western Population of Cirrhotic Patients pp.1534-4681, 2018, https://doi.org/10.1245/s10434-018-6730-0