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Clinicopathological assessment of steatohepatitic hepatocellular carcinoma
Kenji Yamaoka1, Satoshi Saitoh2, Keiichi Kinowaki3
1Department of Hepatology, Toranomon Hospital, Japan.
Insights
Diagnosing steatohepatitic hepatocellular carcinoma (SH-HCC) is possible by combining imaging techniques. This study compared SH-HCC with other liver cancers, finding key differences in patient background and pathology.
Area of Science:
- Hepatocellular Carcinoma Research
- Oncology Imaging
- Gastroenterology
Background:
- Hepatocellular carcinoma (HCC) is a primary liver malignancy.
- Steatohepatitic HCC (SH-HCC) represents a distinct subtype requiring specific diagnostic criteria.
- Understanding clinicopathological differences is crucial for accurate diagnosis and management.
Purpose of the Study:
- To compare the clinicopathological features of typical SH-HCC with other HCC subtypes.
- To evaluate the diagnostic accuracy of various imaging modalities for SH-HCC.
- To identify key differentiating factors between SH-HCC and other HCCs.
Main Methods:
- Retrospective analysis of 486 untreated HCC patients undergoing hepatectomy.
- Comparison of patient demographics, laboratory data, and imaging findings (ultrasound, CT, MRI).
- Application of Liver Imaging Reporting And Data System (LI-RADS) for CT/MRI assessment.
Main Results:
- SH-HCC patients were older and had higher rates of hepatitis B virus (HBV) infection and nonalcoholic steatohepatitis (NASH).
- Diabetes, hyperlipidemia, larger tumor size, and background steatosis were significantly associated with SH-HCC.
- Combined imaging (ultrasound, CT, MRI) improved SH-HCC diagnostic accuracy, with 87% classified as LI-RADS LR-5.
Conclusions:
- Combined ultrasonography, CT, and MRI show promise for diagnosing SH-HCC.
- Clinicopathological features and imaging findings differentiate SH-HCC from other HCC types.
- Further validation of combined imaging protocols for SH-HCC diagnosis is warranted.
Aim:
To compare the clinicopathological features of typical steatohepatitic HCC (SH-HCC) with other HCCs.
Methods:
Subjects were 486 patients with untreated HCC who underwent hepatectomy at our hospital from January 2015 to December 2020. We compared patient backgrounds, preoperative laboratory data, imaging findings (ultrasonography, computed tomography [CT], and magnetic resonance imaging [MRI]), and postoperative pathological findings (tumor and background of liver). The Liver Imaging Reporting And Data System (LI-RADS) was used to examine CT and MRI findings.
Results:
Typical SH-HCCs were significantly different from other HCCs with respect to age, hepatitis B virus (HBV) infection, and nonalcoholic steatohepatitis (NASH). Diabetes and hyperlipidemia were also significantly more common. Regarding histopathology, tumor size and background steatosis were significantly different between groups. Although ultrasonography, CT, and MRI could each alone diagnose SH-HCCs with a diameter < 20 mm in ≥ 50% of patients, the combined use of these tests improved diagnostic accuracy. By LI-RADS, 87% of SH-HCC cases were classified as LR-5, which are considered to be malignant tumors.
Conclusions:
It seems possible to diagnose SH-HCC by combining ultrasonography, CT, and MRI.
