| Budget Amount *help |
¥1,800,000 (Direct Cost: ¥1,800,000)
Fiscal Year 1998: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1997: ¥1,200,000 (Direct Cost: ¥1,200,000)
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| Research Abstract |
The purpose of this study is to analyze the correlation between intranodular blood supply evaluated by CT during arterial portography (CTAP) and CT during hepatic arteriography (CTA) and the grade of malignancy of hepatocytic nodules associated with liver cirrhosis based on the classification by Liver Cancer Study Group of Japan, and to evaluate the appropriateness of the diagnosis of grade of malignancy by CTAP and/or CTA in comparison with the natural course of the nodules. CTAP and CTA findings were compared to the histological diagnosis among 201 nodules in 139 cirrhotic patients. On CTAP, adenomatous hyperplasia (AH) mainly demonstrated almost the same portal supply relative to the surrounding liver (group A), atypical Ahs (AAH) decreased portal flow (group B), well-differentiated hepatocellular carcinomas (wd-HCC) partial absence of portal supply (group C), and modelately or poorly differentiated HCCs (mp-HCC) absence of portal supply (group D), respectively. The ratios of the ab
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ove groupes in each histological groups were statistically significant compared to those in the other groups. CTA findings were also devided into four groups, the same arterial supply (group a), decreased arterial supply (group b), partially increased arterial supply (group c), and increased arterial supply (group d). There was a tendency that Ahs showed group a, AAHs group b, wd-HCCs group c, without statistically significance. All of mp-HCCs demonstrated group d. There was a statistically significant correlation between the four groups and the grades of nodules, in the order of A, B, C, D and a, b, c, d from low to high grade of malignancy. The malignant transformation ratios of the nodules in each groups in 176 nodules were compared. Malignant transformation was defined as more than half of a nodule was stained on CTA or was shown as perfusion defect on CTAP. With increase in grade of malignancy of CTAP findings, malignant transformation ratio was increased. On the other hand, there was a discrepancy between the grade in the groups classified by CTA findings and their prognosis, because, group a includes two different conditions, AH and AAH or ewd-HCCs. On the combination of CTAP and CTA, no malignant transformation was seen in the nodules with group A and a, 30% malignant transformation in the nodules with group B or b, and more than 90% malignant transformation in the nodules with type C or type c during 24 months. This result well corresponded with the grade of malignancy diagnosed by CTAP and CTA. The evaluation of blood supply by arteriographic CT was considered to be valuable to estimate the grade of malignancy of these nodules, to make clear human hepatocarcinogenesis, and to determine the treatment method. Less
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