Cong Wenming

The biopathologic characteristics of dna content of hepatocellular carcinomas

A gross morphologic classification of 66 small hepatocellular carcinomas (SHCC, ⩽3 cm in diameter) was made and DNA content of 30 SHCC and 26 large hepatocellular carcinomas (LHCC, >3 cm in diameter) was determined by image analysis technology. The three types of SHCC are as follows: type I, noncapsule type; type II, capsule type; and type III, infiltrative type. Of the SHCC, 73.3% had diploid DNA content, and 84.6% of LHCC had aneuploid DNA content. The postoperative 5‐year survival rate of patients with SHCC was 62.1%, which is higher than the rate of 27.7% of patients with LHCC. There was no correlation between tumor size and serum alpha‐fetoprotein (AFP) levels. The results suggest that the period when SHCC are 3 cm in size may be important as the changes of DNA stemlines and biological characteristics would occur then. The SHCC of <3 cm reflect relatively benign biological behavior of early hepatocellular carcinoma and this period is the best opportunity for the clinician to get the best prognosis. Currently determination of serum AFP is still one of the possible and effective methods to early finding SHCC.

Primary hepatocellular carcinoma in women of mainland china a clinicopathologic analysis of 104 patients

The clinicopathologic characteristics of 104 hepatectomy samples from female patients with primary hepatocellular carcinoma (PHC) were compared with similar samples from 900 male patients with primary hepatocellular carcinoma; results of this comparison were studied. The male‐to‐female ratio was 8.7:1. The mean age of female patients with PHC was 46.2 years, which was approximately 3 years younger (49.1 years) than that of male patients with PHC. The frequency of associated liver cirrhosis (LC) was 49% in women with PHC and 68.2% in men with PHC (P < 0.01). The mean age of the female patients without LC was 43.2 years, more than 4 years younger (47.9 years) than that of the male patients. The mean ages of female and male patients with LC were 49.1 years and 49.8 years, 6 and 2 years older than that of their corresponding groups without LC, respectively. The positive rates of serum hepatitis B surface antigen (HBsAg) were 70.8% in the men and 59.7% in the women. The 5‐year postoperative survival rates were 50% in the women and 25.7% in the men (P < 0.01). It is suggested that the development of PHC in women appears at a younger age than that of PHC in men in China and usually is associated with a lower frequency of LC and a more satisfactory postoperative prognosis.

Hilar Cholangiocarcinoma with Synchronous Metastases to Breast and Skeletal Muscle： A Case Report and Literature Review

Hilar cholangiocarcinoma has been reputed as a slow growth tumor in the past. Skeletal muscle is one of the most unusual sites of metastasis from any malignancy. We report herein a case of hilar cholangiocarcinoma with synchronous metastases to skeletal muscle and breast, and review the literature. The patient was a 48-year-old woman who presented with jaundice and weight loss. An inoperable hilar cholangiocarcinoma was diagnosed. She was treated with a combination of endoscopic plastic stent biliary drainage and three-dimensional conformal radiotherapy (3DCRT). Good response was achieved. Ten months later, she exhibited with a painful metastatic mass in the muscle rectus femoris of left thigh and a painless mass in the left breast. She underwent operation to relieve the pain, but died from liver failure after 8 months. The literature only offers isolated cases of cholangiocarcinoma with distant metastases, of which the common sites were cervical lymph node, bone, and portal venous system. Most patients were presented with multiple metastases with extensive local disease.

Quantitative studies on the DNA content and morphometric features of liver cell dysplasia

The DNA content and morphometric features of hepatocellular carcinoma (HCC) and liver cell dysplasia (LCD), including nuclear area, nuclear perimeter, nuclear maximum diameter and nuclear circle diameter, were quantitatively determined by means of image analysis technology. The results showed that in comparison with normal hepatocytes, LCD had a markedly increased DNA content and nuclear morphometric parameters, but the values were lower than those for HCC. LCD showed a slight increase in nuclear atypia represented by the nuclear irregular index, which was also less than HCC. The findings indicate that LCD may be a precancerous lesion of HCC, to the cells in an abnormal proliferative state.

Chronic acalculous cholecystitis: correlation of clinical assessment, laboratory data and final histopathology

Abstract Objective To summarize and analyze the clinical and histopathological features of chronic acalculous cholecystitis (CAC) and to investigate the diagnosis and surgical treatment of chronic acalculous cholecystit. Methods The study subjects were 39 patients with chronic biliary symptoms but no evidence of stones in the gallbladder by B ultrasonography and magnetic resonance cholopancreatography (MRCP) (CAC group). The CCC group consisted of 66 patients taken randomly from concurrent all patients of chronic calculous cholecystitis (CCC). All patients accepted fibergastroscopy, B ultrasonography, MRCP, laboratory examination preoperatively. We retrospectively analyzed the clinical features, B ultrasonography and MRCP findings, histopathological results and clinical outcomes between the two groups. Results All the 39 patients were diagnosed by clinical symptoms, B ultrasonography, fatty meal gallbladder contractability studies under ultrasound, fibergastroscopy and magnetic resonance cholangiopancreatography (MRCP), whats more, they were pathologically verified postoperatively. In all patients, there was a complete absence of gallbladder wall contractability. Mucosa epithelial defect was found in 21 patients in CAC group (53.8%) and 16 patients in CCC group (24.2%) respectively ( P P P P P -value >0.05. Conclusion Chronic acalculous cholecystitis could be diagnosed by symptoms, ultrasound, fatty meal gallbladder contractability studies under untrasoundand MRCP. The optimal treatment of chronic acalculous cholecystitis characterized by thickened arteriole wall and mucosa epithelial defect is cholecystectomy.

Microsatellite Alterations on Chromosome 8 of Hepatocellular Carcinoma

AbstractTo study the features of microsatellite alterations on chromosome 8 and their association with clinicopathological characteristics of hepatocellular carcinoma (HCC). Ten highly-polymorphic microsatellite markers on chromosome 8 were selected to be detected for loss of heterozygosity (LOH), microsatellite instability (MSI) and allelic imbalance (AI) in 56 HCC using MegaBACE 500 automatic DNA analysis system. LOH was found in 37 of 56 HCC (66.1%) on at least 1 locus, the top three loci were D8S261 (53.5%), D8S1721 (52.5%) and D8S1771 (52.5%). LOH on D8S277 was significantly higher in cases with positive serum HBsAg than in those with negative HBsAg (P<0.01). Similarly, LOH on D8S261‵D8S298 and D8S1733 occurred more frequently in patients with HBsAg negative than those with HBsAg positive (P<0.01). LOH on D8S298 and D8S1771 was more frequent in those tumors larger than 3cm in size (P<0.05 or P<0.01). LOH frequencies of D8S1721 were significantly higher in cases with absent or not intact tumor capsule than in those with intact tumor capsule (P<0.05). LOH on D8S298 and D8S1771 were more frequently detected in tumors with intrahepatic metastasis than in those without (P<0.01). MSI was found in 12.5% (7/56) cases, and AI was found in 19.6% (11/56), no correlation was found between MSI and AI and clinicopathological characteristics of HCC. Frequent microsatellite alterations on chromosome 8 were existed in HCC. LOH, which represents tumor suppressor gene pathway, plays a more important role in hepatocarcinogenesis; MSI representing mismatch repair gene pathway ranks next. LOH at a particular locus is associated with the clinicopathological parameters of human HCC.