Peritumoral ductular reaction: a poor postoperative prognostic factor for hepatocellular carcinoma.
BACKGROUND
The role of ductular reaction (DR) in hepatocellular carcinoma (HCC) remains to be elucidated.


METHODS
In this study, we tried to uncover possible effect by correlating peritumoral DR in a necroinflammatory microenvironment with postoperative prognosis in HCC. The expression of peritumoral DR/CK19 by immunohistochemistry, necroinflammation and fibrosis were assessed from 106 patients receiving curative resection for HCC. Prognostic values for these and other clinicopathologic factors were evaluated.


RESULTS
Peritumoral DR significantly correlated with necroinflammation (r = 0.563, p = 3.4E-10), fibrosis (r = 0.435, p = 3.1E-06), AFP level (p = 0.010), HBsAg (p = 4.9E-4), BCLC stage (p = 0.003), TNM stage (p = 0.002), multiple nodules (p = 0.004), absence of tumor capsule (p = 0.027), severe microscopic vascular invasion (p = 0.031) and early recurrence (p = 0.010). Increased DR was significantly associated with decreased RFS/OS (p = 4.8E-04 and p = 2.6E-05, respectively) in univariate analysis and were identified as an independent prognostic factor (HR = 2.380, 95% CI = 1.250-4.534, p = 0.008 for RFS; HR = 4.294, 95% CI = 2.255-8.177, p = 9.3E-6 for OS) in multivariate analysis.


CONCLUSIONS
These results suggested that peritumoral DR in a necroinflammatory microenvironment was a poor prognostic factor for HCC after resection.
Minhui
M
Xu
Feng
F
Xie
Guangyang
G
Qian
Yingying
Y
Jing
Shanshan
S
Zhang
Lu
L
Gao
Tao
T
Zheng
Mengchao
M
Wu
Tumor Immunology & Gene Therapy Center, Eastern Hepatobiliary Hospital, The Second Military Medical University, Changhai Road, Shanghai 200438, China. jiameiyang@gmail.com.
Jiamei
J
Yang
Lixin
L
Wei
D000328:Adult; D001653:Bile Ducts, Intrahepatic / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016009:Chi-Square Distribution; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006505:Hepatitis / Q000097:blood / Q000473:pathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D053539:Keratin-19 / Q000032:analysis; D008103:Liver Cirrhosis / Q000097:blood / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009336:Necrosis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D059016:Tumor Microenvironment; D000509:alpha-Fetoproteins / Q000032:analysis
C097353:AFP protein, human; D014408:Biomarkers, Tumor; D053539:Keratin-19; D000509:alpha-Fetoproteins