PDF(Pubmed)
Abstract：
The macroscopic appearance of a tumor such as hepatocellular carcinoma (HCC) may be defined as its phenotype which is de facto dictated by its genotype. Therefore, macroscopic characteristics of HCC are unlikely random but rather reflect genomic traits of cancer, presumably acting as a valuable source of information that can be retrieved and exploited to infer prognosis. This review aims to provide a comprehensive overview of the available data on the prognostic value of macroscopic characterization in HCC. A total of 57 studies meeting eligible criteria were identified, including patients undergoing liver resection (LR; 47 studies, 83%) or liver transplant (LT; 9 studies, 16%). The following macroscopic variables were investigated: tumor size (n = 42 studies), number of nodules (n = 28), vascular invasion (n = 24), bile duct invasion (n = 6), growth pattern (n = 15), resection margin (n = 11), tumor location (n = 6), capsule (n = 2) and satellite (n = 1). Although the selected studies provided insightful data with notable prognostic performances, a lack of standardization and substantial gaps were noted in the report and the analysis of gross findings. This topic remains incompletely covered. While the available studies underscored the value of macroscopic variables in HCC prognostication, important lacks were also observed. Macroscopic characterization of HCC is likely an underexploited source of prognostic factors that must be actively explored by future multidisciplinary research.
摘要：
诸如肝细胞癌(HCC)的肿瘤的宏观外观可以被定义为其表型,其事实上由其基因型决定。因此,HCC的宏观特征不太可能是随机的，而是反映癌症的基因组特征，可能是一个有价值的信息来源，可以检索和利用来推断预后。这篇综述旨在提供有关HCC宏观表征预后价值的可用数据的全面概述。总共确定了57项符合合格标准的研究，包括接受肝切除术的患者(LR；47项研究，83%）或肝移植（LT；9项研究，16%)。研究了以下宏观变量：肿瘤大小(n=42项研究)，结节数量（n=28），血管浸润（n=24），胆管侵犯（n=6），生长模式(n=15)，切除边缘（n=11），肿瘤位置（n=6），胶囊（n=2）和卫星（n=1）。尽管选定的研究提供了具有显著预后表现的有见地数据，报告和总体调查结果分析指出，缺乏标准化和巨大差距。这个话题仍然没有完全覆盖。虽然现有研究强调了宏观变量在HCC预后中的价值，还观察到了重要的缺失。HCC的宏观表征可能是预后因素的未充分利用来源，必须通过未来的多学科研究来积极探索。
