title: Clinicopathologic features between multicentric occurence and intrahepatic metastasis of multiple hepatocellular carcinomas related to HBV.
abstract: OBJECTIVE
  To clarify the incidence of multicentric occurrence (MO) and intrahepatic metastasis (IM) for hepatocellular carcinoma (HCC) related to hepatitis B virus (HBV) in China and to identify the differences between them.
  
  
  METHODS
  Histopathologic features of multiple tumors in 82 cases with HCC were analyzed. The two groups, the origin was determinable as of multicentric occurrence or as of intrahepatic metastasis, were analyzed for their survival rate, disease-free survival and clinicopathologic differences.
  
  
  RESULTS
  According to histological findings, 19.5% and 69.5% patients were considered to be MO and IM, respectively. In total 73 cases from the histopathological method were selected and divided into group MO (16 cases) and the group IM (57 cases). Analysis of stepwise regression identified that: Child's stage, cholinesterase (host factors), tumor size, histological grade and positive portal vein invasion (tumor factors) were the most important discriminating factors between MO and IM (p<0.05). As for their prognosis, Kaplan-Meier and Log rank test showed the survival rate in group MO was significantly better than that in the group IM (p=0.003). No statistical significance was found between the disease-free survival in group MO and that in group IM (p=0.141). The analysis of Cox's proportional hazards model showed that tumor type (MO or IM) and Child's stage were the important prognostic factors (p=0.002 and 0.014, respectively).
  
  
  CONCLUSIONS
  The incidence of MO in patients with multiple HCCs related to HBV is only about 20%, which is lower than that of Japan. Child's stage, cholinesterase (host factors), tumor size, histological grade and positive portal vein invasion (tumor factors) are the most important discriminating factors between MO and IM. The prognosis of patients with MO compared to IM is significantly better and tumor type (MO or IM) and Child's stage are important prognostic factors.
authors.affiliation: Department of Hepatobiliary Surgery, Cancer Hospital of Tianjin Medical University, Huanhu Western Road, Hexi District, Tianjin 300060, PR China. jianwang04@yahoo.com.cn
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Yan
authors.initials: Y
authors.lastname: Sun
authors.forename: Hong
authors.initials: H
authors.lastname: Zheng
authors.forename: Yunlong
authors.initials: Y
authors.lastname: Cui
authors.forename: Haixin
authors.initials: H
authors.lastname: Li
authors.forename: Hongyuan
authors.initials: H
authors.lastname: Zhou
authors.forename: Xishan
authors.initials: X
authors.lastname: Hao
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary* / Q000821:virology; D005260:Female; D006509:Hepatitis B / Q000473:pathology*; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000473:pathology* / Q000821:virology; D011379:Prognosis; D015996:Survival Rate