肝細胞癌及び境界病変の悪性度と結節内血行の関連及びその生物学的性状に関する研究

• Material Type: 文書・図像類
• Title: 肝細胞癌及び境界病変の悪性度と結節内血行の関連及びその生物学的性状に関する研究
• Author/Editor: 松井, 修; Matsui, Osamu
• Author Heading: 松井, 修; Matsui, Osamu
• Publication Date: 2001-10-22
• Publication Date (W3CDTF): 2001-10-22
• Alternative Title: Correlation between the intranodular blood supply and the grade of malignancy of hepatocellular nodules associated with liver cirrhosis
• Periodical title: 平成10(1998)年度 科学研究費補助金 基盤研究(C) 研究成果報告書概要 = 1998 Fiscal Year Final Research Report Summary
• No. or year of volume/issue: 1997 – 1998
• Volume: 1997 – 1998
• Pages: 3p.-
• Text Language Code: jpn
• Subject Heading: 肝細胞癌; 肝硬変; 動注CT; 腺腫様過形成; 早期肝細胞癌; 悪性度診断; 門脈造影下CT; 肝動脈造影下CT; Hepatocellular carcinoma; Liver cirrhosis; arteriographic CT; Adenomatous hyperplasia; early hepatocellular carcinoma; Diagnosis of the grade of malignancy; CT during arterial portography; CT during hepatic arteriography
• Target Audience: 一般
• Note (General): 金沢大学医学部; 本研究では経動脈性門脈造影下CT(CT during arterial portography;CTAP)と肝動脈造影下CT(CT during hepatic arteriography;CTA)による結節内血行支配診断と日本肝癌研究会による組織型との関連を検討し、これらの結節の悪性度診断における有用性を明らかにすることを目的とした。その結果の概要については平成9年度の報告書に記載したが以下のごとくである。対象はCTAPあるいはCTAが施行されたのち組織学的に確診された201結節である。CTAP上結節内門脈血流は周辺肝と同等(A)、やや低下(B)、一部欠損(C)、全体が欠損(D)に分類され、腺腫様過形成(AH)はAを、異型AH(AAH)はBを、高分化肝癌(wd-HCC)はCを、中ないし低分化肝癌(mp-HCC)はDを示す割合が他の組織型に比し有意に高かった。CTA上の結節内動脈血流は、周辺肝と同等(I)、低下(II)、一部増加(III)、全体に増加(IV)に分類され、mp-HCCがIVを示す割合が他の組織型に比し有意に高かった。またAHがIを、AAHがIIを、wd-HCCがIIIを示す傾向がみられた。初期の高分化肝癌はCTAP、CTAでいずれもAAHとwd-HCCの中間の血行を示した。また、結節内血行支配と結節の生物学的悪性度を自然経過観察結節で検討した。結節の悪性化を結節がDあるいはIVを示すようになることと定義した。CTAPあるいはCTAを6カ月以上の間隔で繰り返し施行した176結節の非治療結節についてその悪性化率をKaplan-Meier法で検討した。AおよびI型を示す結節では経過観察期間内(約2年)で悪性化したものはなく、BあるいはII型を示すものは約30%が悪性化し、CあるいはIII型を示すものは約90%が悪性化した。すなわち、結節内血行支配診断による結節の悪性度評価は結節の生物学的悪性度とも良好に相関することが示された。以上の結果より結節内血行支配の画像しよる評価は肝硬変における種々の肝細胞性結節の臨床的取り扱いの決定に有用であり、大きな意義があると考えられた。; 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 above 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.; 研究課題/領域番号:09670920, 研究期間(年度):1997 – 1998; 出典：研究課題「肝細胞癌及び境界病変の悪性度と結節内血行の関連及びその生物学的性状に関する研究 」課題番号09670920（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （https://kaken.nii.ac.jp/ja/report/KAKENHI-PROJECT-09670920/096709201998kenkyu_seika_hokoku_gaiyo/）を加工して作成
• DOI: 10.24517/00066012
• Access Restrictions: 限定公開
• Related Material: https://kaken.nii.ac.jp/search/?qm=10019961; https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09670920/; https://kaken.nii.ac.jp/ja/report/KAKENHI-PROJECT-09670920/096709201998kenkyu_seika_hokoku_gaiyo/
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 金沢大学 : 金沢大学学術情報リポジトリKURA