[The interstitial response and postoperation recurrent mechanism in liver cancer]

Immunoactive cell group markers and glycoproteins of extracellular matrix and basement membrane (fibronectin, laminin, type IV collage) in 156 human hepatocellular carcinomas and their surrounding tissues were localized with immunoperoxidase technique. T lymphocytes were the major immunoactive cells in the regions of local invasion in liver cancer. The distributing patterns of the glycoproteins were similar to the results of previous reports, mainly localized in the surrounding cancer cells, interstitium and vessel walls or sinusoids in tumor, and tumor capsule. The patients, whose hepatocarcinomas showed stronger cell immunoactivity (T and help T cells were in the majority) and higher expression of glycoproteins of extracellular matrix and basement membrane had a longer tumor-free survival (63.2 to 12.8 months) and lower recurrences (P < 0.01). Of the 156 patients 92.9%, 82.6%, 65.4%, 44.2% and 30.8% and 1, 2, 3, 4 and 5 postoperative tumor-free years respectively with a total currence rate of 53.2% (83 patients). In the 83 recurrences, 65 were intrahepatic subclinical, which were promptly reresected 78.3%, recurrence related factors included tumor number and size, capsule infiltration, and portal veins involvement. Being different from those with single node, capsulated hepatocellular carcinomas and multiple/daughter ones had invisible tumor cells disseminated to the remnant liver. Those without capsule infiltration had a low recurrence rate, which agrees to the hypothesis that capsules can bar the dissemination of tumor cells. Additional results show that postoperative tumor recurrence is mainly pertinent to histopathological characteristics of the primary focus. According to the phenomenon that nearly 63.1% of recurrent liver carcinomas are located at the ipsilateral segment of the primary ones, we emphasize that the occurrence and recurrence of liver carcinoma are mainly unicentral.