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Peritumoral ductular reaction: a poor postoperative prognostic factor for hepatocellular carcinoma Xu M; Xie F; Qian G; Jing Y; Zhang S; Gao L; Zheng T; Wu M; Yang J; Wei LBMC Cancer 2014[Feb]; 14 (ä): 65BACKGROUND: The role of ductular reaction (DR) in hepatocellular carcinoma (HCC) remains to be elucidated. METHODS: In this study, we tried to uncover possible effect by correlating peritumoral DR in a necroinflammatory microenvironment with postoperative prognosis in HCC. The expression of peritumoral DR/CK19 by immunohistochemistry, necroinflammation and fibrosis were assessed from 106 patients receiving curative resection for HCC. Prognostic values for these and other clinicopathologic factors were evaluated. RESULTS: Peritumoral DR significantly correlated with necroinflammation (r = 0.563, p = 3.4E-10), fibrosis (r = 0.435, p = 3.1E-06), AFP level (p = 0.010), HBsAg (p = 4.9E-4), BCLC stage (p = 0.003), TNM stage (p = 0.002), multiple nodules (p = 0.004), absence of tumor capsule (p = 0.027), severe microscopic vascular invasion (p = 0.031) and early recurrence (p = 0.010). Increased DR was significantly associated with decreased RFS/OS (p = 4.8E-04 and p = 2.6E-05, respectively) in univariate analysis and were identified as an independent prognostic factor (HR = 2.380, 95% CI = 1.250-4.534, p = 0.008 for RFS; HR = 4.294, 95% CI = 2.255-8.177, p = 9.3E-6 for OS) in multivariate analysis. CONCLUSIONS: These results suggested that peritumoral DR in a necroinflammatory microenvironment was a poor prognostic factor for HCC after resection.|Adult[MESH]|Bile Ducts, Intrahepatic/chemistry/*pathology/surgery[MESH]|Biomarkers, Tumor/analysis[MESH]|Carcinoma, Hepatocellular/blood/chemistry/mortality/*pathology/surgery[MESH]|Chi-Square Distribution[MESH]|Disease Progression[MESH]|Disease-Free Survival[MESH]|Female[MESH]|Hepatectomy[MESH]|Hepatitis/blood/pathology[MESH]|Humans[MESH]|Kaplan-Meier Estimate[MESH]|Keratin-19/analysis[MESH]|Liver Cirrhosis/blood/pathology[MESH]|Liver Neoplasms/blood/chemistry/mortality/*pathology/surgery[MESH]|Male[MESH]|Middle Aged[MESH]|Multivariate Analysis[MESH]|Necrosis[MESH]|Neoplasm Recurrence, Local[MESH]|Neoplasm Staging[MESH]|Proportional Hazards Models[MESH]|Risk Factors[MESH]|Time Factors[MESH]|Treatment Outcome[MESH]|Tumor Microenvironment[MESH]|alpha-Fetoproteins/analysis[MESH] |
