小肝癌临床病理学研究进展与展望

早诊早治是提高肝癌远期疗效最直接和最重要的途径.对手术切除的微小肝癌(≤1 cm)、小肝癌(≤3 cm)、中肝癌(3～5 cm)和大肝癌(>5 cm)进行临床病理学特征对比研究显示,≤3 cm的小肝癌具有以DNA二倍体为主、分化较好、生长相对缓慢、多有包膜形成、少有远癌旁子灶和癌栓发生、易于根治性切除以及术后远期生存率高等特点.这表明处于该生长阶段的肝癌既是生物学特性由早期相对良性向晚期明显恶性演变的重要时机,也是根治性治疗获得较好疗效的重要时机.因此,加强对≤3 cm小肝癌的早期诊治和生物学特性多阶段演变特征的研究,应是今后肝癌临床和病理学研究中需要重点关注的课题.

Abstract：

Early detection and treatment of hepatocellular carcinoma (HCC) is one of the most direct and effective ways to improve the long-term outcome of patients with HCC. The comparative study on clinicopathological characteristics of surgically resected micro HCC (≤1 cm), small HCC(≤3 cm), middle HCC (3-5 cm), and large HCC (>5 cm) showed that ≤3 cm small HCC had the features of DNA diploidy, well differentiation, relatively slow growth, encapsulation, rare long-distance metastatic foci and thrombosis, easy to be radically resected and long-term postoperative survival. It is suggested that HCC growing to about ≤3 cm is an important growth phase when the change of pathobiological characteristics of HCC from a relatively benign to a more malignant behavior would occur. This is also the important time to carry out radical treatment to get better results. Therefore,further research on the early diagnosis and treatment as well as the pathobiological features of small HCC ≤3 cm should be undertaken as one of the key clinical and pathological studies in the future.

Progress and prospect on the clinicopathological study of small hepatocellular carcinoma

Early detection and treatment of hepatocellular carcinoma (HCC) is one of the most direct and effective ways to improve the long-term outcome of patients with HCC. The comparative study on clinicopathological characteristics of surgically resected micro HCC (≤1 cm), small HCC(≤3 cm), middle HCC (3-5 cm), and large HCC (>5 cm) showed that ≤3 cm small HCC had the features of DNA diploidy, well differentiation, relatively slow growth, encapsulation, rare long-distance metastatic foci and thrombosis, easy to be radically resected and long-term postoperative survival. It is suggested that HCC growing to about ≤3 cm is an important growth phase when the change of pathobiological characteristics of HCC from a relatively benign to a more malignant behavior would occur. This is also the important time to carry out radical treatment to get better results. Therefore,further research on the early diagnosis and treatment as well as the pathobiological features of small HCC ≤3 cm should be undertaken as one of the key clinical and pathological studies in the future.