肝癌栓塞化疗后的病理学研究

PATHOLOGIC STUDY OF THE HEPATOCELLULAR CARCINOMA AFTER CHEMOEMBOLIZATION

本文研究了15例肝细胞癌经肝动脉栓塞化疗后的组织病理学变化。患者年龄25～72岁,男性13例,女性2例。显著的组织形态学特点可归纳为(1)在肿瘤区域有不同数量的血管内皮增生、管壁增厚及透明变性和管腔闭塞;(2)栓塞化疗3天以后癌组织发生广泛性凝固性坏死,坏死的肿瘤组织周围常有炎细胞浸润或泡沫细胞积聚,(3)癌巢间胶原纤维组织增生,并常聚结在一起或呈纤维化改变,将癌细胞分隔或包绕起来;(4)癌块周围形成肿瘤性包膜;(5)肿瘤区域可发生钙化或骨化。另外,作者还探讨了肝癌栓塞化疗后的组织形态变化与预后的关系。

Pathologic features of 15 patients with a distinctive histologic variant of hepatocellular carcinoma after hepatic arterial chemoembolization are summarized. The patients age ranged from 25 to 72 years. 13 were men and 2 women. The distinctive histologic features may be ascribed to: (1) The vascular changes were endothelial proliferation, marked thickening of wall, hyalinization or occlusion of the lumen in the tumor region; (2) Massive coagulative necrosis of cancerous tissue already occurred 3 days after chemoembolization. The periphery of necrotic tttmor tissue usually was associated with inflammatory cell infiltration or foamy histocyte accumulation; (3) Abundant fibrous stroma or fibrosis were found between the neoplastic hepatocytes: (4) The encapsulation was found outside in carcerous mass; (5) The calcification and ossification occurred in some cases. In addition, we also discussed the correlation between histological morphology of hepatocellular carcinoma after chemoembolization and prognosis.