摘要目的 分析高分化肝细胞癌(WD-HCC)的临床病理特点,提出病理诊断和鉴别诊断标准.方法 对73例WD-HCC进行临床资料复习、病理大体标本及HE、免疫组织化学染色观察.结果 73例WD-HCC中乙型肝炎病毒(HBV)和/或丙型肝炎病毒(HCV)阳性占94.5％ (69/73),肝硬化者占80.8％ (59/73);肝细胞密度增加者占95.9％(70/73);肝窦明显扩张且形状不规则者占89.0％ (65/73);小梁结构明显者占89.0％ (65/73);胞质嗜酸性或嗜碱性增强者占90.4％ (66/73);腺样结构者占16.4％ (12/73),伴有灶性脂肪变性者占42.4％(31/73).结论 明确了WD-HCC的组织病理诊断要点,对WD-HCC的诊断及其与肝异型增生结节、局灶结节状增生、肝细胞腺瘤的鉴别诊断有重要的临床意义.

abstractsObjective To analyze the clinicopathologic characteristics of well-differentiated hepatocellular carcinoma (WD-HCC),and to find clues for its pathologic diagnosis and differential diagnosis.Methods Seventy-three cases of WD-HCC were studied with clinical data analysis,gross and microscopic examination.Results Among the 73 cases,the prevalence of HBV (+) and/or HCV (+) was 94.5％ (69/73),liver cirrhosis was 80.8％ (59/73),increased hepatic cell density was 95.9％ (70/73),dilated and irregular hepatic sinus was 89.0％ (65/73),prominent trabecularism was 89.0％ (65/73),increased cytoplasmic eosinophilia or basophilia was 90.4％ (66/73),glandular-like structure was 16.4％ (12/73,and fatty degeneration was 42.4％ (31/73).Conclusions There are important clinicopathologic features associated with WD-HCC.These features are useful in the differential diagnosis of WD-HCC with dysplastic nodule (DN),focal nodular hyperplasia (FNH) and hepatocellular adenoma (HA).