title: [Dysplastic nodule of liver versus early hepatocellular carcinoma: a clinicopathologic and prognostic study].
abstract: OBJECTIVE
  To study the clinical features, pathologic findings and prognosis of patients with dysplastic nodules of liver (DN) and early hepatocellular carcinomas (eHCC).
  
  
  METHODS
  One hundred and forty-five archival cases previously diagnosed as DN or eHCC or well-differentiated HCC during the period from 2000 to 2009 were retrieved and reevaluated with the new diagnostic criteria by two experienced pathologists, according to International Consensus Group for Hepatocellular Neoplasia (ICGHN) 2008. Immunohistochemical study (EnVision method) for CD34, HSP70, glutamine synthetase, glypican 3 and Ki-67 was carried out. The original diagnosis and diagnosis after review were compared and correlated with the survival data of the patients, with statistical analysis.
  
  
  RESULTS
  With the new criteria, 16 cases were diagnosed as low-grade DN, 50 cases as high-grade DN, 72 cases as DN with microinvasion, 7 cases as advanced HCC. Slide review showed no diagnostic discrepancy in 112 cases (77.2%). Amongst the 33 (22.8%) underdiagnosed cases, there were 7 cases of advanced HCC initially diagnosed as DN or DN with microinvasion and 26 cases of eHCC initially diagnosed as high-grade DN. Kaplan-Meier analysis showed that the diagnosis of high-grade DN or early HCC carried no statistically significant difference in overall survival (P = 0.778, 0.677) or disease-free survival (P = 0.949, 0.700) in all patients and in patients with no history of HCC. The co-existence of advanced HCC in patients with DN or eHCC significantly correlated with overall survival (P = 0.004) but not with disease-free survival (P = 0.079).
  
  
  CONCLUSIONS
  The new diagnostic criteria by ICGHN 2008 are useful in delineating high-grade DN and eHCC. The overall survival and disease-free survival of patients with eHCC or high-grade DN undergoing hepatectomy show no statistically significant difference. Patients with DN or eHCC have better prognosis than patients with advanced HCC, though there is still a high risk of tumor recurrence.
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Lingli
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Yunshan
authors.initials: Y
authors.lastname: Tan
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Haiying
authors.initials: H
authors.lastname: Zeng
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Yingyong
authors.initials: Y
authors.lastname: Hou
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Jianfang
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China. E-mail:ji.yuan@zs-hospital.sh.cn.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Ji
mesh_terms: D018952:Antigens, CD34 / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D002471:Cell Transformation, Neoplastic; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018840:HSP70 Heat-Shock Proteins / Q000378:metabolism; D006498:Hepatectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000378:metabolism; D008103:Liver Cirrhosis / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008113:Liver Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015996:Survival Rate
chemical_list: D018952:Antigens, CD34; D018840:HSP70 Heat-Shock Proteins; D019394:Ki-67 Antigen