高分化肝细胞癌的病理形态学特征及其病理学诊断与鉴别诊断  

Study on the morphological features, pathologic diagnosis and differential diagnosis of well-differentiated hepatocellular carcinoma

作　　者：韦立新[1] 杜经丽[1] 王玉兰[1] 石怀银[1] 赵景民[2] 

机构地区：[1]解放军总医院病理科,北京100853 [2]解放军第三○二医院病理诊断与研究中心

出　　处：《中华病理学杂志》2014年第7期459-462,共4页Chinese Journal of Pathology

摘　　要：目的 分析高分化肝细胞癌（WD-HCC）的临床病理特点,提出病理诊断和鉴别诊断标准.方法 对73例WD-HCC进行临床资料复习、病理大体标本及HE、免疫组织化学染色观察.结果 73例WD-HCC中乙型肝炎病毒（HBV）和/或丙型肝炎病毒（HCV）阳性占94.5％ （69/73）,肝硬化者占80.8％ （59/73）;肝细胞密度增加者占95.9％（70/73）;肝窦明显扩张且形状不规则者占89.0％ （65/73）;小梁结构明显者占89.0％ （65/73）;胞质嗜酸性或嗜碱性增强者占90.4％ （66/73）;腺样结构者占16.4％ （12/73）,伴有灶性脂肪变性者占42.4％（31/73）.结论 明确了WD-HCC的组织病理诊断要点,对WD-HCC的诊断及其与肝异型增生结节、局灶结节状增生、肝细胞腺瘤的鉴别诊断有重要的临床意义.Objective To analyze the clinicopathologic characteristics of well-differentiated hepatocellular carcinoma （WD-HCC）,and to find clues for its pathologic diagnosis and differential diagnosis.Methods Seventy-three cases of WD-HCC were studied with clinical data analysis,gross and microscopic examination.Results Among the 73 cases,the prevalence of HBV （＋） and/or HCV （＋） was 94.5% （69/73）,liver cirrhosis was 80.8% （59/73）,increased hepatic cell density was 95.9% （70/73）,dilated and irregular hepatic sinus was 89.0% （65/73）,prominent trabecularism was 89.0% （65/73）,increased cytoplasmic eosinophilia or basophilia was 90.4% （66/73）,glandular-like structure was 16.4% （12/73,and fatty degeneration was 42.4% （31/73）.Conclusions There are important clinicopathologic features associated with WD-HCC.These features are useful in the differential diagnosis of WD-HCC with dysplastic nodule （DN）,focal nodular hyperplasia （FNH） and hepatocellular adenoma （HA）.

关 键 词：癌 肝细胞 腺瘤 肝细胞 诊断 鉴别 

分 类 号：R735.7[医药卫生—肿瘤]