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Histopathological changes in hepatocellular carcinoma after hepatic arterial embolization
Summary
Hepatic arterial embolization (HAE) effectively treats hepatocellular carcinoma (HCC) by causing tumor necrosis. Encapsulated tumors and vascular injury correlate with necrosis, making encapsulated HCC a good candidate for HAE therapy.
Area of Science:
- Hepatobiliary Surgery
- Interventional Radiology
- Oncopathology
Background:
- Hepatocellular carcinoma (HCC) is a common primary liver cancer.
- Hepatic arterial embolization (HAE) is a palliative treatment for advanced HCC.
- Histopathological changes post-HAE for HCC are not well-documented.
Purpose of the Study:
- To investigate the histopathological alterations in liver neoplasms following HAE.
- To identify factors influencing necrosis and treatment efficacy in HCC patients undergoing HAE.
Main Methods:
- Histopathological analysis of 39 HCC cases treated with HAE.
- Comparison with 11 HCC cases treated with digital selective angiography (DSA).
- Evaluation of tumor pathology, grade, necrosis, capsular changes, HAE frequency, vascular injury, and lymphocytic infiltration.
Main Results:
- Significant tumor necrosis observed in 20 out of 39 HAE-treated cases (6 cases with 100% necrosis, 14 with 30-95% necrosis).
- Necrosis was associated with tumor pathology, encapsulation, and vascular injury.
- No significant necrosis was noted in DSA-treated cases.
- Histological grade, HAE frequency, and lymphocytic infiltration did not correlate with necrosis.
Conclusions:
- HAE is an effective treatment for advanced HCC, inducing significant tumor necrosis.
- Encapsulated HCC demonstrates a favorable response to HAE.
- Vascular injury and tumor encapsulation are key indicators for successful HAE therapy in HCC.