Computed Tomography Assessment of the Vascularization Degree of Hepatocellular Carcinoma in the Noncirrhotic Liver
American Journal of Clinical and Experimental Medicine
Volume 3, Issue 1, January 2015, Pages: 24-31
Received: Dec. 31, 2014;
Accepted: Jan. 15, 2015;
Published: Jan. 28, 2015
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Ulyana N. Tumanova, Department of Radiological Methods of Diagnosis and Treatment, A.V. Vishnevsky Institute of Surgery, Ministry of Health of Russia, Moscow, Russia; Department of Pathology, Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia
Grigoriy G. Karmazanovsky, Department of Radiological Methods of Diagnosis and Treatment, A.V. Vishnevsky Institute of Surgery, Ministry of Health of Russia, Moscow, Russia
Alexander I. Shchyogolev, Department of Pathology, Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia
An important CT-characteristic at a diagnostic of liver tumors is the determination of its vascularity. To study the characteristics of blood tissue of hepatocellular carcinoma (HCC) with different degrees of differentiation by CT. The work is based on the clinical and morphological comparisons performed in 55 patients (34 men and 21 women aged 15-83 years) with hepatocellular carcinoma (HCC) without accompanying liver cirrhosis. In the preoperative stage all patients was carried spiral computed tomography (CT) with bolus contrast enhancement (on the four phases of the study). Was evaluated parameters of CT density and degree of nodes HCC vascularization. Morphologic study of histological preparations of operation material from 16 patients was diagnosed high-differentiated, 33 - moderately differentiated, and 6 - poorly differentiated HCC. At the immunohistochemical preparations with reaction to CD34 was determined by the number and the total cross-sectional area of vessels in sight of HCC tissue. The maximum values of CT density in the arterial phase were observed at the nodes moderately differentiated HCC. In the venous phase the greatest values of density as well as the venous increase was registered in high-differentiated HCC. The most vascularised (hypervascular) tumor is high-differentiated HCC, and the least vascularized - poorly differentiated HCC by CT. At morphometric study of the maximum values of the number and the total cross-sectional area of the blood vessels are installed in high-differentiated HCC tissues, the minimum - in the tissue of low-grade HCC. CT with bolus contrast enhancement allows studying the characteristics of blood supply of HCC varying degrees of differentiation. Determine the true measure of total CT-vascularization of the tumor tissue must be done with consideration of the increase concentration difference coefficient (ICDC).
Ulyana N. Tumanova,
Grigoriy G. Karmazanovsky,
Alexander I. Shchyogolev,
Computed Tomography Assessment of the Vascularization Degree of Hepatocellular Carcinoma in the Noncirrhotic Liver, American Journal of Clinical and Experimental Medicine.
Vol. 3, No. 1,
2015, pp. 24-31.
K. A. McGlynn, L. Tsao, A.W. Hsing, S.S. Devesa, and J.F. Fraumeni Jr, International trends and patterns of primary liver cancer, Int J Cancer. 2001; 94(2): 290-6.
H. B. El-Serag, and K. L. Rudolph, Hepatocellular carcinoma: epidemiology and molecular carcinogenesis, Gastroenterology. 2007; 132(7): 2557-6.
State of cancer care in Russia in 2013 / Eds. A. D. Caprin, V. V. Starinskiy, and G.V. Petrova. M.: MNIOI them. P.A. Herzen of Russian Ministry of Health, 2014. p.235 [in Russian]
F. Trevisani, M. Frigerio, V. Santi, A. Grignaschi, and M. Bernardi, Hepatocellular carcinoma in non-cirrhotic liver: a reappraisal, Dig Liver Dis. 2010; 42(5):341-7.
A. C. Silva, J. M Evans, A. E. McCullough, M. A. Jatoi, H. E. Vargas and A.K. Hara, MR Imaging of hypervascular liver masses: A review of current techniques, Radiographics. 2009; 29(2):385-402.
S. Gaddikeri, M. F. McNeeley, C. L. Wang, P. Bhargava, M. K. Dighe, M. M. Yeh, T.J. Dubinsky, O. Kolokythas and N. Lalwani, Hepatocellular carcinoma in the noncirrhotic live, Am J Roentgenol. 2014; 203(1): W34-47.
T. K. Lee, R. T. Poon, A. P. Yuen, M. T. Ling, X. H. Wang, Y. C. Wong, X. Y. Guan, K. Man, Z. Y. Tang, and S. T. Fan, Regulation of angiogenesis by Id-1 through hypoxia-inducible factor-1alpha-mediated vascular endothelial growth factor up-regulation in hepatocellular carcinoma, Clin Cancer Res. 2006;12(23): 6910-19.
A. X. Zhu, D. G. Duda, D. V. Sahani, and R. K. Jain, HCC and angiogenesis: possible targets and future directions, Nat Rev Clin Oncol. 2011;8(5): 292-301.
A. I. Shchyogolev, E. A. Dubova, and U. N. Tumanova, Vascularization of hepatocellular carcinoma tissue depends on its differentiation degree, Bull of Experimental Biology and Medicine. 2012; 153(4):490-4.
WHO classification of tumours of the digestive system / Eds. N. D. Theise, M. P. Curado, S. Franceschi et al. - Lyon: IARC, 2010. P.205-16.
H. B. El-Serag, Hepatocellular carcinoma: recent trend in the United States, Gastroenterology. 2004; 127(5, Suppl 1): S27-S34.
A. Qayyum, A. Graser, A. Westphalen, R. B. Merriman, L. D. Ferrell, B. M. Yeh, and F. V. Coakley, CT of benign hyper vascular liver nodules in autoimmune hepatitis, Am J Roentgenol. 2004; 183(6):1573-6.
M. Hofer, CT teaching manual. Georg Thieme Verlag, 2000. – 176 p.
N. K. Lee, S. Kim, G. H. Kim, T. Y. Jeon, D. H. Kim, H. J. Jang, and do Y Park, Hypervascular subepi-thelial gastrointestinal masses: CT-pathologic correlation, Radiographics. 2010; 30(7):1915-34.
O. Matsui, M. Kadoya, T. Kameyama, J. Yoshikawa, T. Takashima, Y. Nakanuma, M. Unoura, K. Kobayashi, R. Izumi, M. Ida, et al. Benign and malignant nodules in cirrhotic livers: distinction based on blood supply, Radiology. l99l;178(2):493-7.
A. D. Cohen, and N. E. Kemeny, An update on hepatic arterial infusion chemotherapy for colorectal cancer, The Oncologist. 2003; 8(6):553-6.
M. Kudo, Imaging diagnosis of hepatocellular carcinoma and premalignant/borderline lesions, Semin Liver Dis. 1999; 19(3):297-309.
L. Bolondi, S. Gaiani, N. Celli, R. Golfieri, W.F. Grigioni, S. Leoni, A.M. Venturi, and F. Piscaglia, Characterization of small nodules in cirrhosis by assessment of vascularity: the problem of hypovascular hepatocellular carcinoma, Hepatology. 2005; 42(1):27-34.
E. K. Outwater, Imaging of the liver for hepatocellular cancer, Cancer Control. 2010; 17(2):72-82.
J. Bruix, and M. Sherman, Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma, Hepatology. 2005; 42(5):1208-36.
M. Kudo, Morphological diagnosis of hepatocellular carcinoma: special emphasis on intranodular hemodynamic imaging, Hepatogastroenterology. 1998;45(suppl 3):1226-31.
M. Kojiro, Pathology of hepatocellular carcinoma. Massachusetts: Blackwell Publishing, 2006, p.63-76.
Y. Nakashima, O. Nakashima, C.C. Hsia, M. Kojiro, and E. Tabor, Vascularization of small hepatocellular carcinomas: correlation with differentiation, Liver.1999; 19(1):12-8.
M. Kin, T. Torimura, T. Ueno, S. Inuzuka, and K. Tanikawa, Sinusoidal capillarization in small hepatocellular carcinoma, Pathol Int. 1994;44(10-11):771-8.
A. Kamaya, K. E. Maturen, G. A. Tye, Y. I. Liu, N. N. Parti, and T. S. Desser, Hypervascular liver lesions, Semin Ultrasound CT MR. 2009;30(5):387-407.
C-N. Chen, Y-M. Cheng, J-T. Liang, P. H. Lee, F. J. Hsieh, R. H. Yuan, S. M. Wang, M. F. Chang, and K. J. Chang, Color doppler vascularity index can predict distant metastasis and survival in colon cancer patients, Cancer Res. 2000;60(11):2892-7.
W. Zeng, A. S. H. Gouw, M. C. van den Heuvel, J. Molema, S. Poppema, E. J. van der Jagt, and K. P. de Jong, Hepatocellular carcinomas in cirrhotic and noncirrhotic human livers share angiogenic characteristics, Ann Surg Oncol. 2010; 17(6):1564-71.
Y. Yao, Y. Pan, J. Chen, X. Sun, Y. Qiu, and Y. Ding, Endoglin (CD105) expression in angiogenesis of primary hepatocellular carcinomas: analysis using tissue microarrays and comparisons with CD34 and VEGF, Ann Clin Lab Sci. 2007;37(1):39-48.
J. P. Paschoal, V. Bernardo, N. H. S. Canedo, O. D. Ribeiro, A. Caroli-Bottino, and V. L. Pannain, Microvascular density of regenerative nodule to small hepatocellular carcinoma by automated analysis using CD105 and CD34 immunoexpression, BMC Cancer. 2014; 14:72.
I. Chebib, M. T. Shabani-Rad, M. S. Chow, Y. Zhang, and Z. H. Gao, Microvessel density and clinicopathologic characteristics in hepatocellular carcinoma with and without cirrhosis, Biomarker Insights. 2007; 14(2):59-68.
R. T. Poon, I. O. Ng, C. Lau, W. C. Yu, Z. F. Yang, S. T. Fan, and J. Wong, Tumor microvessel density as a predictor of recurrence after resection of hepatocellular carcinoma: a prospective study, J Clin Oncol. 2002; 20(7):1775-85.
L. Messerini, L. Novelli, and C. E. Comin, Microvessel density and clinicopathological characteristics in hepatitis C virus and hepatitis B virus related hepatocellular carcinoma, J Clin Pathol. 2004; 57(8):867-71.
X. Y. Sun, Z. D. Wu, X. F. Liao, and J. Y. Yuan, Tumor angiogenesis and its clinical significance in pediatric malignant liver tumor, World J Gastroenterol. 2005;11(5):741-3.
O. N. El-Assal, A. Yamanoi, Y. Soda, M. Yamaguchi, M. Igarashi, A. Yamamoto, T. Nabika, and N. Nagasue, Clinical significance of microvessel density and vascular endothelial growth factor expression in hepatocellular carcinoma and surrounding liver: possible involvement of vascular endothelial growth factor in the angiogenesis of cirrhotic liver, Hepatology. 1998; 27(6):1554-62.
L. Hlatky, P. Hahnfeldt, and J. Folkman, Clinical Application of Antiangiogenic Therapy: Microvessel Density, What It Does and Doesn’t Tell Us, J Natl Cancer Inst. 2002;94(12):883-93.