title: Factors regulating tumor pressure in cases of small hepatocellular carcinoma.
abstract: OBJECTIVE
  There is scare information regarding tumor pressure in hepatocellular carcinoma. As the tumor diameter increases, histological manifestations become more diverse. Therefore, studies based on relatively small tumors are needed in order to search for those underlying factors that are directly related to tumor pressure in hepatocellular carcinoma. The purpose of this study was to determine which factors regulate tumor pressure in cases of hepatocellular carcinoma where the diameter of the tumor is 3cm or less.
  
  
  METHODS
  The study included 54 patients with small hepatocellular carcinoma in whom tumor pressure had been determined and in whom the tumor had been confirmed histologically. Tumor pressure was determined percutaneously under ultrasonographic guidance.
  
  
  RESULTS
  Hepatic tissue pressure (p = 0.01), tumor size (p < 0.01), number of tumors (p = 0.01), degree of tumor differentiation (p < 0.01), ultrasonographic halo (p < 0.01), angiographic tumor staining (p < 0.01) and angiographic tumor vessel (p = 0.03) all showed significant correlation with tumor pressure. Multivariate analysis revealed that angiographic tumor staining (p = 0.001), hepatic tissue pressure (p = 0.013), and tumor size (p = 0.044) were significant factors associated with tumor pressure.
  
  
  CONCLUSIONS
  It was suggested that tumor pressure in small hepatocellular carcinoma was mainly regulated through development of the neovasculature.
authors.affiliation: Department of Gastroenterology, Chikushi Hospital, Fukuoka University, Japan. tueki@cis.fukuoka-u.ac.jp
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ueki
authors.forename: Seigo
authors.initials: S
authors.lastname: Sakaguchi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tanaka
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Oka
authors.forename: Keiji
authors.initials: K
authors.lastname: Tohara
authors.forename: Tsuneyoshi
authors.initials: T
authors.lastname: Yao
authors.forename: Makoto
authors.initials: M
authors.lastname: Okumura
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000503:physiopathology*; D045604:Extracellular Fluid / Q000502:physiology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis