Outcomes of dysplastic nodules in human cirrhotic liver: A clinicopathological study

Citation
S. Seki et al., Outcomes of dysplastic nodules in human cirrhotic liver: A clinicopathological study, CLIN CANC R, 6(9), 2000, pp. 3469-3473
Citations number
19
Categorie Soggetti
Oncology
Journal title
CLINICAL CANCER RESEARCH
ISSN journal
10780432 → ACNP
Volume
6
Issue
9
Year of publication
2000
Pages
3469 - 3473
Database
ISI
SICI code
1078-0432(200009)6:9<3469:OODNIH>2.0.ZU;2-N
Abstract
The number of dysplastic nodules detected clinically has increased since pa tients with hepatitis virus-associated cirrhosis, who are at increased risk for hepatocellular carcinoma (HCC), began to undergo regular cancer survei llance. Although it is potentially important to determine which type(s) of nodule may be prone to progress to HCC, outcomes of dysplastic nodules have not been fully investigated. This prompted us to examine the outcomes of d ysplastic nodules in cirrhotic patients clinicopathologically. We studied 3 3 dysplastic nodules of <20 mm in maximum diameter, diagnosed by fine needl e aspiration biopsy under ultrasonography (US). These nodules were clinical ly followed, mainly by US examination, for up to 70 months. When the nodule s enlarged or exhibited changes on US, they were histologically reexamined by second biopsy. Surprisingly, 15 of the 33 nodules (45.5%) disappeared, 1 4 nodules (42.4%) remained unchanged, and only 4 nodules (12.1%) progressed to HCC. The latter 4 nodules were an hyperechoic on US and were composed o f clear cells with fatty change or small cells with increased nuclear densi ty, and in all 4 patients serum was positive for hepatitis C virus antibody . Univariate analyses revealed that, although not significant, the hyperech oic nodules or nodules with small cell change showed a higher HCC progressi on rate in comparison with the hypoechoic nodules or the nodules without sm all cell change. In summary, most of the dysplastic nodules we followed dis appeared or remained unchanged, but some progressed to HCC. Hyperechoic nod ules in patients with hepatitis C virus-associated cirrhosis, which show sm all cell change with increased nuclear density, may be prone to progress to HCC.