Cell kinetics in the study of hepatocellular carcinoma

Cell kinetics of normal, preneoplastic and neoplastic tissue in man have been thoroughly investigated during the last decade. Different variables that reflect tumour cell proliferation have been identified to correlate with the clinical outcome of the patients. Even so, we do not know whether some of these variables really assess tumour cell proliferation or tumour growth, are meaningful when compared with conventional predictive prognostic features, are reproducible between observers and laboratories or can be measured routinely in consecutive series of patients. For example, there are few studies of the cell kinetics of hepatocellular carcinoma (HCC) and the search for new prognostic indicators is of utmost importance for such a disease. Tumour volume doubling time appeared to be associated to survival for patients with small HCC submitted to different combination treatments. A preliminary analysis showed a relationship between 3H-Thymidine labelling index (3H-TdR LI) and survival for patients with HCC treated with hepatectomy alone or in combination with systemic chemotherapy. The results could indicate the usefulness of 3H-TdR LI following the natural history of the HCC, as reported for other tumour types. The cell proliferation rate defined by 3H-TdR LI is more accurate than by tumour volume and the requirement for only one small biopsy sample should also make it possible to determine the 3H-TdR LI in HCC.