Preoperative prediction of poorly differentiated components in small-sized hepatocellular carcinoma for safe local ablation therapy.
BACKGROUND
Poorly differentiated hepatocellular carcinoma (HCC) has a malignant potential such as frequent microvascular invasion even if the tumor is smaller than 3 cm in diameter. The aim of this study was to clarify the preoperative predictors of poorly differentiated HCC for safe local ablation therapy.


METHODS
Sixty-six patients underwent a hepatic resection for solitary small-sized HCC (<or=3 cm) were included in this study. According to the postoperative histological examination, the patients were divided into a "poorly differentiated group" (n = 17) and a "well/moderately differentiated group" (n = 49). This study investigated the clinicopathological factors and imaging findings, and elucidated the predictive factors of the poorly differentiated type.


RESULTS
In a univariate analysis, serum hepatitis B surface antigen positive, hepatitis C virus antibody negative, alpha-fetoprotein level, des-gamma-carboxy prothrombin level, and a high contrast-to-noise ratio (CNR) in T2-weighted MR imaging were significantly associated with the poorly differentiate type. In a multivariate analysis, a high CNR in T2-weighted MR imaging was the only independent predictor of the poorly differentiated type. In the postoperative pathological findings, portal vein invasion and intrahepatic metastasis were significantly frequent in the poorly differentiated group.


CONCLUSIONS
The CNR in T2-weighted MR imaging is a useful tool to predict poorly differentiated HCC preoperatively.
Imai
Katsunori
K
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Beppu
Toru
T
Nakayama
Yoshiharu
Y
Ishiko
Takatoshi
T
Horino
Kei
K
Komori
Hiroyuki
H
Masuda
Toshiro
T
Hayashi
Hiromitsu
H
Okabe
Hirohisa
H
Baba
Yoshihumi
Y
Watanabe
Masayuki
M
Takamori
Hiroshi
H
Awai
Kazuo
K
Yamashita
Yasuyuki
Y
Baba
Hideo
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged