Morphological differences between hepatocellular carcinoma and hepatocellular carcinomalike lesions

Area of Science:

• Hepatobiliary pathology
• Quantitative histology
• Diagnostic imaging analysis

Background:

• Differentiating well-differentiated hepatocellular carcinoma (HCC) from benign liver lesions like focal nodular hyperplasia (FNH), regenerative nodular hyperplasia (RNH), and hepatocellular adenoma (HCA) is clinically significant.
• Histopathological assessment traditionally relies on subjective interpretation, necessitating objective quantitative methods.

Purpose of the Study:

• To establish quantitative morphometric criteria for differentiating well-differentiated HCC from HCC-like lesions.
• To identify reliable histopathological features that distinguish HCC from benign mimics.

Main Methods:

• Histopathological and morphometrical analyses of 208 liver disease cases using an image analyzer.
• Statistical analysis including logistic regression and chi-squared tests.
• Evaluation of six specific morphometric features and 13 descriptive histopathological findings.

Main Results:

• Six morphometric features identified as practical indicators for HCC: nuclear shape factor (<0.93), nuclear variance (>5%), trabecular cord width (>3 cells), nucleocytoplasmic ratio (>0.3), cellular density (>40 cells), and nuclear dimension (>50 µm²).
• Logistic analysis accurately separated HCC from non-HCC conditions, including HCC-like lesions.
• Fibrous capsule, portal triads, mosaiclike patterns, and tumor vessels were significantly different between HCC-like lesions and well-differentiated HCC (p<0.005).

Conclusions:

• Quantitative morphometric analysis provides an objective basis for differentiating well-differentiated HCC from benign liver lesions.
• Established morphometric and histopathological features can significantly improve diagnostic accuracy in liver pathology.
• These quantitative indicators are valuable tools for pathologists in diagnosing HCC.