title: Fibrosis and inflammatory activity in noncancerous tissue and mitotic index of cancer tissue in patients with hepatocellular carcinoma: relationship to clinicopathological factors and prognosis after hepatic resection.
abstract: This study was designed to provide a histopathological analysis focusing on fibrosis (staging) and necroinflammatory reaction (grading, hepatitis activity index: HAI) in noncancerous liver tissue, and mitotic index (MI) in cancerous liver tissue to predict prognosis in 81 patients with chronic hepatitis or cirrhosis who underwent hepatectomy for hepatocellular carcinoma (HCC). The incidence of grade 2/3 and higher HAI was higher in patients with viral hepatitis C. The incidence of grade 2/3 was associated with vascular invasion of HCC, postoperative liver dysfunction, and cancer recurrence. Higher MI (> or = 5) was significantly associated with vascular invasion, poor histological differentiation, and recurrence rate (P < 0.05). Multivariate analysis showed that higher grade was the factor strongly associated with cancer recurrence (odds ratio: 10.621, P = 0.006). Higher MI correlated with overall patient survival (P < 0.05) by univariate analysis. Grading and MI are the useful prognostic markers for predicting tumor recurrence and patient survival.
authors.affiliation: First Department of Surgery, Nagasaki University School of Medicine, Nagasaki, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Kenji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Shibasaki
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Morino
authors.forename: Megumi
authors.initials: M
authors.lastname: Yoshinaga
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Tohru
authors.initials: T
authors.lastname: Nakagoe
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Ayabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016461:Chemoembolization, Therapeutic; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy; D006509:Hepatitis B / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006526:Hepatitis C / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D008940:Mitotic Index; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012306:Risk; D015996:Survival Rate
chemical_list: D005472:Fluorouracil