title: Preoperative prediction of poorly differentiated components in small-sized hepatocellular carcinoma for safe local ablation therapy.
abstract: 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.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Imai
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Ishiko
authors.forename: Kei
authors.initials: K
authors.lastname: Horino
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Komori
authors.forename: Toshiro
authors.initials: T
authors.lastname: Masuda
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Okabe
authors.forename: Yoshihumi
authors.initials: Y
authors.lastname: Baba
authors.forename: Masayuki
authors.initials: M
authors.lastname: Watanabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takamori
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: 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