In vitro uptake of bromodeoxyuridine by human hepatocellular carcinoma and its relation to histopathologic findings and biologic behavior

The in vitro uptake of bromodeoxyuridine (BrdU) by hepatocellular carcinoma (HCC) cells was studied in 30 hepatectomized patients. Labeling of the nuclei by BrdU expressed as labeling index (LI) was 5.6 +/- 3.2% (mean +/- standard deviation), with a considerable variation from case to case. The mean LI in Grade III to IV cancers (less differentiated, by Edmondson and Steiner's classification, 11.1 +/- 2.1%) was significantly larger (P less than 0.001) than that in Grade I to II cancers (more differentiated, 4.5 +/- 2.0%). Capsule formation was found in all 17 patients except one (94%) with a low DNA synthetic HCC (LI less than 6.0%) compared with seven of 13 (54%) with a high DNA synthetic HCC (LI greater than or equal to 6.0%, P less than 0.02). The 2-year survival rate after surgery was significantly higher (P less than 0.02), and intrahepatic metastasis was significantly less (P less than 0.05) in the former group than in the latter. The BrdU LI of HCC tumors showed a strong correlation with histopathologic findings and the biologic behavior of HCC.