CHANGES IN BLOOD-SUPPLY IN SMALL HEPATOCELLULAR-CARCINOMA - CORRELATION OF ANGIOGRAPHIC IMAGES AND IMMUNOHISTOCHEMICAL FINDINGS

Background/Aims: To assess the changes occurring in blood flow with gr owth in small hepatocellular carcinomas, we analyzed the angiographic features and immunohistochemical findings in 35 hepatocellular carcino mas less than 2 cm in diameter. Methods: Hepatocellular carcinomas wer e evaluated by digital subtraction angiography (DSA), ultrasound angio graphy with intraarterial CO2 microbubbles (USAG), and computed tomogr aphy during arterial portography (CTAP), Immunohistochemically, hepato cellular carcinomas were evaluated using QB-end/10 (QB) monoclonal ant ibody. Results: All 18 moderately-differentiated hepatocellular carcin omas stained positively with QB antibody, No hepatocellular carcinomas without attenuation on CTAP were positive by immunohistochemistry, an d two hepatocellular carcinomas with attenuation on CTAP also lacked s taining, We observed four hepatocellular carcinomas without hypervascu larity on DSA or USAG, which stained positively with QB antibody; thes e hepatocellular carcinomas had fatty metamorphosis. Conclusions: 1. I mmunohistochemical findings are closely associated with angiographic f indings regarding changes in blood supply, 2. All moderately-different iated hepatocellular carcinomas have characteristics of hypervasculari ty, both by angiographic images and by immunohistochemistry. 3. The in crease in arterial blood supply occurs later than the decrease in port al perfusion, which may indicate that the decrease in portal perfusion may not be the direct result of replacement by angiogenesis, 4. Some hepatocellular carcinomas with fatty metamorphosis, which are often hy povascular by angiographic evaluation, have hypervascular immunohistoc hemical characteristics.