門脈内色素注入からみた肝細胞癌の血流動態について

概要

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Identification of the typical portal hemodynamics of small hepatocellular carcinomas (HCC) in the early stage could be useful for a definition of cancerous change. We studied the relationships between areas of the liver stained by a pigment injected into the portal vein supplying HCC or of lesions with characteristics between those of regenerative nodular lesions and HCC during or after surgery and the capsular formation and histological differentiation of the nodule. Seventeen nodules from 14 patients were analyzed histologically. Six were of well-differentiated HCC (10±7mm in diameter, mean±SD) without a capsule. All six nodules had portal areas, but only two nodules were stained by the pigment. Seven nodules were of moderately differentiated HCC (29±26 mm); the pigment stained only one nodule, without a capsule. Four nodules (34±10mm) were completely necrotic because of treatment before surgery. Staining by the pigment was more closely related with capsular formation than differentiation. This finding suggested that portal flow decreases during capsular formation as HCC progresses.
社団法人日本肝臓学会の論文