RT Journal Article
SR Electronic
T1 Facing the enigma of the vascular network in hepatocellular carcinomas in cirrhotic and non-cirrhotic livers
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 102
OP 108
DO 10.1136/jclinpath-2015-203028
VO 69
IS 2
A1 Francesco Vasuri
A1 Silvia Fittipaldi
A1 Francesca Giunchi
A1 Melissa Monica
A1 Matteo Ravaioli
A1 Alessio Degiovanni
A1 Sonia Bonora
A1 Rita Golfieri
A1 Luigi Bolondi
A1 Walter F Grigioni
A1 Gianandrea Pasquinelli
A1 Antonia D'Errico-Grigioni
YR 2016
UL http://jcp.bmj.com/content/69/2/102.abstract
AB Aims In this paper we aimed to analyse the typology and the phenotype of the different vascular modifications in human hepatocellular carcinomas (HCCs) with a new immunomorphological and gene expression approach. We also attempted to correlate these modifications with the histological parameters of tumour aggressiveness and the surrounding liver parenchyma.Methods Ninety-six HCCs (from 80 patients) were retrospectively enrolled, 46 occurring in non-cirrhotic livers, and 50 in livers transplanted for cirrhosis. Histopathological analysis, immunohistochemistry for CD34, Nestin and WT1 and RT-PCR for Nestin, transforming growth factor-β1 (TGFβ1) and insulin-like growth factor 1 (IGF1R) mRNA were performed in all nodules.Results By correlating the CD34 and Nestin immunoreactivity in HCC vasculature with the tumorous architecture, we identified four vascular patterns (named from ‘a’ to ‘d’). Each of them was characterised by different expressions of TGFβ1 and IGF1R mRNA. Pattern a showed CD34-positive/Nestin-negative sinusoids, and was prevalent in microtrabecular lesions. Pattern b showed similar morphology and architecture as pattern a, but with Nestin-positive sinusoids and a significant ‘boost’ in IGF1R and TGFβ1 mRNAs. In patterns c and d a progressive sinusoid loss and a gain of newly formed arterioles were seen. Notably, HCCs with pattern a arose more frequently in cirrhosis (p=0.024), and showed lower incidence of microvascular invasion (p=0.002) and infiltration (p=0.005) compared with HCCs with other patterns.Conclusions Although future studies are surely required, the identification of different vascular profiles in HCCs from cirrhotic and non-cirrhotic livers may help clarify the relationship between HCC progression and aggressiveness.