MORPHOMETRIC AND PATHOLOGICAL-STUDY OF HEPATOCELLULAR-CARCINOMA

Because of its great incidence and poor prognosis the hepatocarcinoma (HCC) has become a first line clinical challenge. This is the reason we have performed a descriptive anatomo-pathological analysis of our own cases and a study of the possible prognostic value of nuclear parameters. Design: We have performed a retrospective study of 83 cases. We reviewed the clinical records and histologic preparations. Methods. We analysed the following parameters: 1) Tumour site; 2) Association to cirrhosis; 3) Microscopic features (cellular type differentation grade, peritumoral lymphocytic infiltration, architecture, mitotic index); 4) Metastatic frecuency and location; 5) Morphometric nuclear parameters (area, perimeter, major diameter, major and minor axis, circle diameter, sphere volume, ellipse volume, shape factor. Results: We highlight the following: 1) 50% of HPC associated to liver cirrhosis; 2) Ascites was more frequent in the tumours located in the right lobe or both lobes than in tumours affecting the left lobe (p<0.005); 3) Macroscopically, the commonest type was the nodular one (47.8%); 4) Microscopically, the commonest findings were as follows: cellular type (93%); differentiation grade type II (61.4%); trabecular architecture (64.9%); lymphocytic infiltration grade I (57.9%); 5) Mean mytotic index was 16.3 m./high power field. 6) There were distant metastases in 81.1% and portal vein invasion in 44.6 %. 7) The nuclear morphometric study did not support any influence on patients' survival. Conclusions. 1) This descriptive analysis allows a morphological data base that is very useful for subsequent morphological or prognostic studies. 2) Our data do not support any influence of nuclear parameters on patients' survival, although we cannot exclude some relation in a greater series.