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Query: UMLS:C0345904 (liver cancer)
 15,188 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Combined hepatocellular-cholangiocarcinoma (HCC-CC) is rare, constituting much less than 5% of all primary liver cancers. Its dual histologic and cytologic differentiation may be a major problem in the differential diagnosis of fine needle aspiration biopsies (FNABs) of the liver. We describe two cases of combined HCC-CC, both examined initially by FNAB. Cytologic smears were markedly cellular, with a population of slightly to moderately pleomorphic neoplastic cells, often arranged in cohesive cords and columns resembling anastomosing hepatic plates. Many of these cells had centrally placed nuclei and a moderate amount of granular, eosinophilic cytoplasm. Other cellular groups were arranged in acinar formations, with eccentric nuclei and intraluminal and cytoplasmic mucin production. Both types of cells were positive for cytokeratin and carcinoembryonic antigen; in one case the carcinoma cells were also focally positive for alpha-fetoprotein. Although these neoplasms may pose diagnostic challenges, our experience suggests that HCC-CC may be suspected or even diagnosed by FNAB.
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PMID:Cytomorphology of combined hepatocellular-cholangiocarcinoma in fine needle aspirates of the liver. A report of two cases. 750 82

The therapeutic effect of transcatheter arterial chemoembolization (TAE) performed on 31 patients with primary liver cancer was evaluated using the following procedures: (1) the alpha-fetoprotein (AFP) reduction rates and prognoses were analyzed according to the tumor reduction rates (TR), and (2) the AFP reduction rates and prognoses were also analyzed according to the tumor necrosis rates (TN) estimated by regarding every region with Lipiodol retention as being necrotic. The following results were obtained. The AFP level was 400 ng/ml or higher in 15 patients (48%). Their AFP reduction rates were as favorably high as 65.4%-99.8% (mean, 88.1%), and the AFP level was normalized in 3 patients. The cumulative survival rates after the initial treatment were relatively high, i.e., 78.4% in the 1st year, 58.1% in the 2nd year, and 38.7% in the 3rd year. These results suggested the effectiveness of the TAE treatment undertaken in this study. Regarding the TR, the tumor was reduced in size by 50% or more in only 5 patients (16%), and most patients had a TR of less than 25%. On the other hand, the majority, 25 patients (81%), had a TN ranging between 50% and less than 100%, including 7 who had a TN ranging between 50% and less than 90% and 18 who had a TN ranging between 90% and less than 100%. There was no significant correlation between the AFP reduction rate and the TN or TR. Regarding evaluation of the cumulative survival rates by TR and TN, the 1-year survival rate was lower in patients having a TR of less than 25% than in those having a TR of 25% or more. Patients having a TN of less than 50% showed a poor outcome as compared with those having a TN of 50% or more. Although the TR was found to be less than 50% in a majority of the patients when the therapeutic effect of TAE on the liver cancer was evaluated according to the TR, many of these patients showed a good outcome. Thus, the conventional efficacy evaluation, in which a tumor reduction of 50% or more is considered to be effective, should be reconsidered. On the other hand, the TN was found to be 50% or more in most of the patients, suggesting the necessity of a more detailed classification of TN. In relation to the survival rate, patients having a TN of less than 50% showed a poor outcome.
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PMID:Evaluation of the therapeutic effect of TAE on primary liver cancer. 751 Oct 68

A 78-year-old female presented with swelling and severe pain in the left forehead secondary to a simple head injury received 1 month previously. On admission, neurological examination was normal. Plain skull x-ray films and computed tomography showed an osteolytic and well-defined mass in the left frontal bone. Bone scintigraphy showed high-uptake areas in the right lower ribs and fifth lumbar vertebra. Blood tests showed slight liver dysfunction and a high alpha-fetoprotein level. Abdominal computed tomography showed a huge mass within the liver. Left common carotid angiography disclosed the enlargement of several feeding arteries arising from the external carotid artery with tumor staining. The bone tumor was removed for histological diagnosis and to reduce the localized pain. The histological diagnosis was a cranial metastasis from hepatocellular carcinoma. She died of ruptured varicose veins of the esophagus approximately 8 months after surgery. Surgery for cranial metastasis from hepatic cancer is only indicated when localized pain or hemorrhage threaten the quality of life.
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PMID:Cranial metastasis of hepatocellular carcinoma in a female--case report. 751 32

Fourteen patients with unrespectable HCC were treated with various interventional radiology (IVR) procedures. The initial therapeutic response was determined using computed tomography (CT) findings, and determinations of serum alpha-fetoprotein (AFP) and protein induced by Vitamin K absence or antagonist-II (PIVKA-II) levels. When CT studies of the initial response to IVR were compared with changes in the serum AFP and PIVKA-II levels, the AFP level was found to correlate more closely than the PIVKA-II levels. The PIVKA-II level correlated more closely than the AFP level in cases with poor response to IVR. Both of these tumor markers should be measured in combination with the diagnostic imagings for follow-up studies of IVR.
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PMID:Clinical evaluation of serum alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels in patients with hepatocellular carcinoma following interventional radiology. 751 71

A total of 28 surgically resected hepatocellular carcinomas, including both fresh-smeared specimens and paraffin-embedded tissues, was stained with alpha-fetoprotein (AFP) antibody. In all cases we measured the DNA contents using microspectrophotometry. In 5 cases, analyses of the nuclear DNA histogram of both the AFP-positive and negative cells from the same specimen were successfully performed. The ratio of the S-G2.M phase of the AFP-positive cells was 2.24 times more than that of the AFP-negative cells. In addition, not only the ratio of S-G2.M phase cells, but also the incidence of aneuploidy pattern of AFP positive stained cases was higher than the negative stained cases. Histologically, the AFP-positive cases contained various differentiated tissues more than the negative cases. From these results, we confirmed that AFP production was related to the growth of HCC, and the results suggest that AFP producing HCC have a higher potential for growth than AFP non-producing HCC.
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PMID:[Microspectrophotometric analysis of nuclear DNA contents related to the presence of alpha-fetoprotein in human hepatocellular carcinoma]. 751 15

In targeted chemotherapy, Lipiodol Ultrafluid was used as a carrier of anticancer drugs; these combinations were termed oily anticancer agents. Arterial injection therapy with these oily anticancer agents was performed in 330 patients with unresectable hepatocellular carcinoma (HCC) and 110 patients with unresectable metastatic liver cancer. The alpha-fetoprotein (AFP) level decreased in 178 of 186 AFP-positive patients with HCC. Tumor size was reduced in 256 of 269 evaluable patients with HCC. The treatment seemed to prolong survival and in 193 HCC patients who were good candidates for therapy (those without Child C liver cirrhosis, without tumor occupying all four segments of the liver, or without extrahepatic spread) the 1-, 2-, and 5-year survival rates were 85, 52, and 34% respectively. In the 110 patients with metastatic liver cancer, the carcinoembryonic antigen level and tumor size were reduced. The 1-, 2-, and 5-year survival rates of these 110 patients were 61, 32, and 22% respectively.
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PMID:Targeted chemotherapy for unresectable primary and metastatic liver cancer. 751 28

Mass screening for liver cancer based mainly on abdominal ultrasound was begun in major cities of Hokkaido, Japan, in November 1981, to enable early detection and treatment of hepatocellular carcinoma (HCC). Serum alpha-fetoprotein levels were also measured to minimize false negative studies. Examinees included those who sought liver disease screening as well as high risk individuals: hepatitis B surface antigen carriers and those with a past or current liver disease, history of blood transfusion, family history of liver cancer, and more recently those with positive anti-hepatitis C antibodies. The examination was carried out on each Saturday and Sunday as one round, and by February 1992 48 rounds had been performed. A total of 8090 individuals were investigated, and HCC was detected in 91 with a detection rate of 1.12%. This rate was 1.6% among 5684 individuals who were selected for high risk. Cumulative rates of survival among these patients were 79.0% at 1 year, 43.8% at 3 years, 19.3% at 5 years and 15.4% at 7 years. These survival rates were comparable with those for the patients with HCC diagnosed during follow-up of chronic liver disease and treated at our hospital. The cost for detecting one HCC patient in this programme was 2,660,000 yen (approximately US$25,000), which was less than those for some other types of cancer in a similar setting. Considering the high detection rate in this programme, we feel that similar programmes should be encouraged and supported.
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PMID:Mass screening for hepatocellular carcinoma: experience in Hokkaido, Japan. 752 21

Lens culimaris agglutinin A-reactive alpha-fetoprotein (AFP L3) and erythroagglutinating phytohemagglutin-reactive alpha-fetoprotein (AFP P4 + P5) were determined by a sensitive method using lectin-affinity electrophoresis coupled with antibody-affinity blotting, and the usefulness of this method for early detection of hepatocellular carcinoma (HCC) was examined. For 72 operated cases of the HCC group including 28 cases of small liver cancer, the AFP value was 124 +/- 198ng/ml (Mean +/- SD); the lectin fraction values for L3 and P4 + P5 were 12.2 +/- 17.9 and 17.9 +/- 17.9%, respectively, which were significantly higher compared with the chronic hepatitis (CH).cirrhosis (LC) group and showed an increasing tendency with an increase in tumor diameter. The cut-off values for distinguishing HCC from CH.LC, determined with the receiver-operating characteristic (ROC) plots, were 10.0 and 15.0% for the L3 and P4 + P5 fractions, respectively, and the positive rates in the patient with HCC were 33.3 and 48.6% for AFP L3 and AFP P4 + P5, respectively, and 59.7% with a combination assay. For small liver cancer, the positive rate was 17.9% with protein induced by vitamin K absence-II (PIVKA-II) and 46.4% with combination assay of AFP L3 and AFP P4 + P5. Also, for HCC below AFP 50ng/ml, a positive rate of 45.0% was obtained. In the CH.LC group, all cases were negative for AFP L3 and 2 of 44 cases (4.5%) were false-positive for AFP P4 + P5.
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PMID:[Early detection of hepatocellular carcinoma with lectin reactive alpha-fetoprotein]. 752 71

Thirteen cases of combined hepatocellular (HCC) and cholangiocellular carcinoma (CCC) were examined. In addition to routine pathology, immunoreactivities for carcinoembryonic antigen, alpha-fetoprotein (AFP), cytokeratin (Cam 5.2 and AE1), epithelial membrane antigen (EMA) and tumor-associated glycoprotein 72 (B72.3) were also examined. The average age of the 13 cases was 64.8 years, which lay between the average ages of pure HCC and CCC cases. They were categorized as separate type (2), collision type (6), and intermingled type (5). AE1 and EMA were the best markers to differentiate the CCC from the HCC area. B72.3 immunoreactivity was detected only in CCC (46%). There were no transitional features between HCC and CCC in two cases of the separate type and two cases of the collision type. However, focal transitional features from HCC to CCC were observed in all cases of the intermingled type and in four of six cases of the collision type. In one case of the intermingled type, many cancer cells contained both bile and mucus simultaneously, and revealed dual immunoreactivities. The conclusions are: 1) the combined type is generated from two sources; one is the intrahepatic double cancer (thoroughly separate type and a part of the collision type) and another is the stem cell origin with diverse phenotypes (intermingled type and a part of the collision tumor); and 2) AE1 was the most helpful marker to differentiate the CCC area from HCC, and other markers, e.g. AFP for HCC and EMA, CEA, and B72.3 for CCC, were also supportive but somewhat limited in the differential diagnosis.
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PMID:An immunohistochemical analysis of 13 cases with combined hepatocellular and cholangiocellular carcinoma. 753 81

This is the first reported case of primary lymphoma of the spleen coexisting with primary hepatocellular carcinoma. A 59-year-old woman was admitted to Ugo town hospital because of general malaise. Physical examination revealed no lymphadenopathy. Laboratory data showed mild anemia, thrombocytopenia, and slight elevation of alpha-fetoprotein (AFP). Ultrasonography of the abdomen revealed a mass in the left lobe of the liver and a mass in the splenic hilus. The liver tumor was presumed to be a primary liver cancer. Ultrasonically guided needle aspiration of the splenic mass was unsuccessful. Subsequently, the patient died of hepatic and renal failure. Autopsy revealed hepatocellular carcinoma and primary splenic non-Hodgkin's lymphoma of the diffuse large cell type.
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PMID:Primary lymphoma of the spleen with hepatocellular carcinoma. 760 94


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