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Updated: May 9, 2026

Mast Cells in the Microenvironment of Hepatocellular Carcinoma Confer Favorable Prognosis: A Retrospective Study using QuPath Image Analysis Software

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Published on: April 12, 2024

Features of massive hepatocellular carcinomas.

Brian I Carr¹, Vito Guerra

¹Departments of aHCC Biology bEpidemiology, IRCCS S. de Bellis, National Institute for Digestive Diseases, Castellana Grotte (BA), Italy.

European Journal of Gastroenterology & Hepatology

|July 19, 2013

Summary

Massive hepatocellular carcinomas (HCCs) are uncommon but share distinct clinical features. High levels of platelets, alpha-fetoprotein (AFP), alkaline phosphatase (ALKP), and gamma-glutamyl transpeptidase (GGTP) characterize these large tumors, with AFP significantly impacting survival.

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Published on: September 30, 2021

Area of Science:

Hepatology
Oncology
Tumor Biology

Background:

Massive hepatocellular carcinomas (HCCs), defined as tumors ≥10 cm, are rare and poorly understood.
Characterizing these large tumors is crucial for understanding their unique biology and clinical behavior.

Purpose of the Study:

To define the clinical characteristics and survival outcomes of patients with massive HCC.
To identify factors associated with tumor size, number, and patient survival in this cohort.

Main Methods:

Retrospective analysis of 344 patients with biopsy-proven, unresectable massive HCC (≥10 cm diameter).
Evaluation of baseline clinical characteristics, including laboratory markers (platelets, AFP, ALKP, GGTP), tumor size, and number.
Survival analysis using a multivariate Cox proportional hazard model.

Main Results:

Massive HCC patients exhibited less severe cirrhosis and higher platelet counts, AFP, ALKP, and GGTP levels compared to controls.
Platelet count, ALKP, and GGTP correlated with tumor size; ALKP correlated with tumor number.
Both ALKP and AFP were significant predictors of overall survival in multivariate analysis.
Survival for massive HCC was comparable to other large HCC tumors.

Conclusions:

Massive HCCs are biologically distinct, indicated by elevated platelets, AFP, ALKP, and GGTP.
AFP's importance in survival, independent of tumor size/number, suggests a role in underlying tumor biology.
Patients with massive HCC warrant active therapeutic consideration, similar to other HCC tumor sizes.