肝癌多段階発癌における良悪性の鑑別

Differentiation between benign and malignant hepatocellular nodule during multistep hepatocarcinogenesis

肝癌は男性では世界の癌死亡の第2位，先進国では男性の癌死亡の第6位に位置する。2012年の統計では新規患者が年間約78万人，年間死亡数が約75万人とされている^1）。

During multistep hepatocarcinogensis process, as the nodular grade of malignancy increase, intranodular portal blood supply gradually decreased, and almost completely disappeared in the moderately or poorly differentiated HCC. In contrast, intranodular arterial supply first decreased in DN and borderline lesions, and then acutely increased in accordance with the elevation of the grade of malignancy. Drainage flow from the nodules, nodular signal intensities of T1 and T2-weighted MRI, SPIO enhanced T2-weighted MRI also change during multistep hepatocarcinogenesis step. Expression of the uptake transporter OATP1B3 in HCC cells significantly correlated with the signal intensity of HCCs in the hepatobiliary phase of EOB enhanced MRI. The expression of uptake transporter OATP1B3 significantly decreases during multistep hepatocarcinogenesis. These knowledge helps us to differentiate benign and malignant nodule on imaging.