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Relationship of angiographic finding with neovascular structure detected by immunohistochemical staining of α‐smooth muscle actin in small hepatocellular carcinoma
Author(s) -
IKEDA KENJI,
SAITOH SATOSHI,
SUZUKI YOSHIYUKI,
KOBAYASHI MASAHIRO,
TSUBOTA AKIHITO,
KOIDA ISAO,
KOBAYASHI MIZUHO,
ARASE YASUJI,
CHAYAMA KAZUAKI,
MURASHIMA NAOYA,
KUMADA HIROMITSU
Publication year - 1998
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.1998.01792.x
Subject(s) - hypervascularity , medicine , hepatocellular carcinoma , pathology , angiography , carcinoma , portography , radiology , cirrhosis , portal hypertension
To elucidate the relationship between angiographic features and histological findings, an immunohistological study of α‐smooth muscle actin was performed in 106 patients with small hepatocellular carcinoma. Arterial dominance or portal blood paucity were found in 73 patients (68.9%) on digital subtraction angiography, 88 (83.0%) on computerized tomographic arterial portography and 87 (82.1%) on carbon dioxide‐enhanced ultrasonography. Among 73 patients with hypervascularity on angiography, 57 (78.1%) had thick‐walled, nuclei‐rich and slender‐shaped vessels (type II), eight (11, 0%) had thin‐walled, nuclei‐poor and oval‐shaped vessels (type I) and the remaining eight had a mixed type of II and I. Conversely, among 33 patients without hypervascularity, five (15.2%) had a type II, 21 (63.6%) had a type I, five had a mixed type and two had no positive vessel. Tumour size, histological classification and amount of non‐triadal vessels were also associated with the angiographic appearance of the tumours. Among varied aspects of the cancer including tumour size, tumour multiplicity, microscopic portal invasion, histological classification, amount of α‐smooth muscle actin‐positive vessels and shape of α‐smooth muscle actin‐positive vessels, multivariate logistic regression analysis demonstrated that the shape of α‐smooth muscle actin‐positive vessels was solely associated with angiographic hypervascularity independently ( P < 0.0001). Although the existence of non‐triadal vessels characterized hepatocellular carcinoma, angiographic hypervascularity was closely associated with the type II vessel. A morphological change of non‐triadal vessel from type I to type II was considered to occur in an early stage of hepatocellular carcinoma.