Clinical Management of Hepatocellular Carcinoma. Conclusions of the Barcelona-2000 EASL Conference

https://www.gastrojournal.org/article/S0016-5085(04)01593-8/pdf

Hepatocellular carcinoma in cirrhosis: incidence and risk factors.

https://aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.1002/hep.1840220341

Terminology of nodular hepatocellular lesions

https://air.unimi.it/bitstream/2434/49917/2/HCC.pdf

Pathologic Diagnosis of Early Hepatocellular Carcinoma: A Report of the International Consensus Group for Hepatocellular Neoplasia

Serum α-fetoprotein for diagnosis of hepatocellular carcinoma in patients with chronic liver disease: influence of HBsAg and anti-HCV status

https://www.gastrojournal.org/article/0016-5085(95)90455-7/pdf

Liver cell dysplasia is a major risk factor for hepatocellular carcinoma in cirrhosis: A prospective study

The evaluation of fine-needle procedures for the diagnosis of focal liver lesions in cirrhosis

To clarify the true nature of liver-cell dysplasia (LCD), a flow cytometric study has been performed. The DNA content of hepatocytes from 26 cases of cirrhosis with diffuse areas of LCD was investigated and compared to that of hepatocytes from 21 control patients with non-neoplastic and neoplastic liver conditions. Flow cytometric analysis was performed on propidium-stained nuclei from archival paraffin-embedded material. Analysis was directed to assessment of diploid as well as non-diploid peaks by calculation of DNA index (DI), using normal hepatocytes present in each sample as individual and specific references. Since only samples containing at least 10,000 nuclei were considered suitable for analysis, 4 of the 26 LCD cases were discarded. Eight of 22 LCD cases had an abnormal DNA content compared with 0/11 non-neoplastic cases (p less than 0.05) and 8/10 hepatocellular carcinomas (p less than 0.05). Non-neoplastic control cases displayed uniformly diploid stemlines whereas hepatocellular carcinomas had in 8/10 cases bimodal or trimodal populations. Thus, LCD is a heterogeneous lesion in terms of ploidy, and the abnormal DNA content observed in some cases supports its pre-neoplastic nature.

Abnormal DNA content in liver-cell dysplasia: a flow cytometric study.

Liver cell dysplasia (LCD) was found in 28 (60%) of 47 patients with hepatocellular carcinoma (HCC); 22 (79%) of them had associated liver cirrhosis. LCD was more frequently observed in posthepatitic cirrhosis (82%) than in the other forms. Carcinoembryonic antigen (CEA), alpha-1-antitrypsin (AAT) and alpha-fetoprotein (AFP), as demonstrated by the peroxidase-antiperoxidase method, were similarly expressed both in normal and in dysplastic cells. Hepatitis B surface antigen was found in eight cases (17%), six of which were associated with LCD. HBsAg was rarely found in dysplastic cells and frequently displayed a peculiar perinuclear pattern. The possible preneoplastic role of LCD is stressed.

Liver cell dysplasia and hepatocellular carcinoma: a histological and immunohistochemical study.

Liver cell dysplasia (LCD) was investigated for hepatitis B virus (HBV) markers, alpha-fetoprotein (AFP) and ferritin by serologic and immunohistochemical methods in 101 patients with cirrhosis. LCD was found in 30 cases (29.7%), with the highest incidence in cases of posthepatitic cirrhosis (67%). In the group of dysplastic cirrhosis (DC) 46.6% of the patients had active HBV infection (hepatitis B surface antigen [HBsAg] serum positivity) compared with 7% of the patients with nondysplastic cirrhosis (NDC) (P less than 0.01). The mean serum AFP concentration was significantly raised in the DC group compared with that in the NDC group (P less than 0.05). In seven patients with LCD at the initial biopsy, the histologic followup showed the persistence of LCD in all cases, and the development of hepatocellular carcinoma (HCC) in three cases. In serologic HBsAg-positive cases, dysplastic cells, at variance with the surrounding liver parenchyma, were almost always negative for tissue HBsAg, and always negative for tissue hepatitis B core antigens (HBcAg). AFP was never detected in either normal or dysplastic cells. Ferritin was found in all cases, but dysplastic foci displayed a lesser amount of this protein. These serologic and immunohistochemical data strongly suggest a preneoplastic significance of LCD. The importance of monitoring cirrhotic patients with LCD and particularly those with HBV infection and/or increased AFP levels with more aggressive follow-up is also stressed.

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/1097-0142%2819860415%2957%3A8%3C1515%3A%3AAID-CNCR2820570813%3E3.0.CO%3B2-J

Ernesto Servida

Papers

Liver cell dysplasia is a major risk factor for hepatocellular carcinoma in cirrhosis: A prospective study

The evaluation of fine-needle procedures for the diagnosis of focal liver lesions in cirrhosis

Abnormal DNA content in liver-cell dysplasia: a flow cytometric study.

Liver cell dysplasia and hepatocellular carcinoma: a histological and immunohistochemical study.

Liver cell dysplasia in cirrhosis. A serologic and immunohistochemical study.