Table 16.
Pathological findings from resected specimen or biopsy specimen
|
Hepatocellular carcinoma n (%) |
Intrahepatic cholangiocarcinoma n (%) |
Combined hepatocellular cholangiocarcinoma n (%) |
||
|---|---|---|---|---|
| Capsule formation | n = 6398 | n = 553 | n = 93 | |
| fc (−) | 1640 (25.6) | 512 (92.6) | 54 (58.1) | |
| fc (+) | 4758 (74.4) | 41 (7.4) | 39 (41.9) | |
| Capsule invasion | n = 4641 | n = 40 | n = 35 | |
| fc‐inf (−) | 1323 (28.5) | 15 (37.5) | 8 (22.9) | |
| fc‐inf (+) | 3318 (71.5) | 25 (62.5) | 27 (77.1) | |
| Septum formation | n = 6177 | n = 525 | n = 80 | |
| sf (−) | 2174 (35.2) | 463 (88.2) | 29 (36.3) | |
| sf (+) | 4003 (64.8) | 62 (11.8) | 51 (63.8) | |
| Serosal invasion | n = 6279 | n = 554 | n = 79 | |
| s0 | 5509 (87.7) | 373 (67.3) | 63 (79.7) | |
| s1 | 605 (9.6) | 133 (24.0) | 13 (16.5) | |
| s2 | 84 (1.3) | 44 (7.9) | 2 (2.5) | |
| s3 (rupture) | 81 (1.3) | 4 (0.7) | 1 (1.3) | |
| Lymph node metastasis | n = 5441 | n = 546 | n = 84 | |
| n0 | 5384 (99.0) | 384 (70.3) | 73 (86.9) | |
| n1 | 57 (1.0) | 162 (29.7) | 11 (13.1) | |
| Portal vein invasion | n = 6560 | n = 578 | n = 95 | |
| vp0 | 4795 (73.1) | 307 (53.1) | 54 (56.8) | |
| vp1 | 1341 (20.4) | 169 (29.2) | 28 (29.5) | |
| vp2 | 190 (2.9) | 41 (7.1) | 8 (8.4) | |
| vp3 | 168 (2.6) | 50 (8.7) | 5 (5.3) | |
| vp4 | 66 (1.0) | 11 (1.9) | 0 (0.0) | |
| Hepatic vein invasion | n = 6560 | n = 573 | n = 94 | |
| vv0 | 5812 (88.6) | 406 (70.9) | 76 (80.9) | |
| vv1 | 607 (9.3) | 134 (23.4) | 14 (14.9) | |
| vv2 | 88 (1.3) | 25 (4.4) | 4 (4.3) | |
| vv3 | 53 (0.8) | 8 (1.4) | 0 (0.0) | |
| Hepatic artery invasion | n = 6474 | n = 549 | n = 81 | |
| va0 | 6413 (99.1) | 505 (92.0) | 81 (100.0) | |
| va1 | 54 (0.8) | 27 (4.9) | 0 (0.0) | |
| va2 | 4 (0.1) | 6 (1.1) | 0 (0.0) | |
| va3 | 3 (0.0) | 11 (2.0) | 0 (0.0) | |
| Bile duct invasion | n = 6507 | n = 550 | n = 93 | |
| b0 | 6284 (96.6) | 272 (49.5) | 80 (86.0) | |
| b1 | 137 (2.1) | 107 (19.5) | 8 (8.6) | |
| b2 | 39 (0.6) | 64 (11.6) | 2 (2.2) | |
| b3 | 33 (0.5) | 76 (13.8) | 2 (2.2) | |
| b4 | 14 (0.2) | 31 (5.6) | 1 (1.1) | |
| Intrahepatic metastasis | n = 6265 | n = 555 | n = 88 | |
| im0 (no metastasis) | 5394 (86.1) | 465 (83.8) | 69 (78.4) | |
| ims (within subsegment) | 170 (2.7) | 14 (2.5) | 3 (3.4) | |
| im1 (within 1 segment) | 394 (6.3) | 41 (7.4) | 8 (9.1) | |
| im2 (within 2 segment) | 205 (3.3) | 23 (4.1) | 5 (5.7) | |
| im3 (within 3 segment) | 102 (1.6) | 12 (2.2) | 3 3.4) | |
| Invasion of surgical margins | n = 6334 | n = 570 | n = 91 | |
| sm (+) with tumor exposure | 467 (7.4) | 93 (16.3) | 14 (15.4) | |
| sm (−) 0 mm | 566 (8.9) | 38 (6.7) | 5 (5.5) | |
| sm (−) ≤5 mm | 1340 (21.2) | 89 (15.6) | 17 (18.7) | |
| sm (−) ≤10 mm | 565 (8.9) | 44 (7.7) | 5 (5.5) | |
| sm (−) >10 mm | 485 (7.7) | 44 (7.7) | 4 (4.4) | |
| sm (−) distance unknown | 2911 (46.0) | 262 (46.0) | 46 (50.5) | |
| Findings in non‐cancerous liver parenchyma | n = 6283 | n = 531 | n = 92 | |
| Normal | 521 (8.3) | 315 (59.3) | 13 (14.1) | |
| Chronic hepatitis, liver fibrosis | 3106 (49.4) | 167 (31.5) | 49 (53.3) | |
| Liver cirrhosis | 2656 (42.3) | 49 (9.2) | 30 (32.6) | |
| Fibrosis (new Inuyama classification) | n = 5020 | n = 329 | n = 70 | |
| F0 (normal) | 411 (8.2) | 176 (53.5) | 8 (11.4) | |
| F1 | 763 (15.2) | 68 (20.7) | 11 (15.7) | |
| F2 | 939 (18.7) | 32 (9.7) | 13 (18.6) | |
| F3 | 852 (17.0) | 19 (5.8) | 15 (21.4) | |
| F4 (liver cirrhosis) | 2055 (40.9) | 34 (10.3) | 23 (32.9) | |
| Activity (new Inuyama classification) | n = 3300 | n = 231 | n = 46 | |
| A0 | 482 (14.6) | 130 (56.3) | 11 (23.9) | |
| A1 | 1585 (48.0) | 74 (32.0) | 20 (43.5) | |
| A2 | 1097 (33.2) | 24 (10.4) | 14 (30.4) | |
| A3 | 136 (4.1) | 3 (1.3) | 1 (2.2) | |
For all parameters, n is the total number of patients, excluding those in the “unknown” category, and (%) is the percentage of n.
A0, no necroinflammatory reaction; A1, mild necroinflammatory reaction; A2, moderate necroinflammatory reaction; A3, severe necroinflammatory reaction; proper hepatic artery; b0, no invasion of bile duct, b1, branches of the bile duct, but not of second order branches; b2, invasion of (or tumor thrombus in) the second order branches of the bile duct; b3, invasion of (or tumor thrombus in) the first order branches of the bile duct; b4, invasion of (or tumor thrombus in) the common hepatic duct; F1, fibrous expansion of portal tract; F2, fibrous septa formation, usually incomplete; F3, bridging fibrous formation accompanying lobular distortion; fc (−), absence of capsule formation; fc (+), presence of capsule formation; b0, absence of invasion of the bile ducts; b1, invasion of (or tumor thrombus in) the third order or more peripheral; fc‐inf (−), absence of cancerous infiltration of the tumor capsule; fc‐inf (+), presence of cancerous infiltration of the tumor capsule; im1, intrahepatic metastasis within the subsegment in which the principal tumor is located; im2, intrahepatic metastasis in two segments; im3, intrahepatic metastasis to three or more segments; ims, intrahepatic metastasis within the subsegment in which the principal tumor is located; sf (−), absence of formation of a fibrous septum within the tumor; sf (+), presence of fibrous septum within the tumor; s0, absence of invasion of the serosa; s1, tumor invasion of the serosa; s2, tumor invasion of adjacent organs; s3, tumor rupture with intraperitoneal bleeding; va0, absence of invasion of the hepatic artery; va1, invasion distal to the second order branches of the hepatic artery, but not of the second order branches; va2, invasion to the second order branches of the hepatic artery; va3, invasion to the left or right hepatic artery, or the im0, absence of intrahepatic metastasis; vp0, absence of invasion of (or tumor thrombus in) the portal vein; vp1, invasion of (or tumor thrombus in) distal to the second order branches of the portal vein, but not of the second order branches; vp2, invasion of (or tumor thrombus in) second order branches of the portal vein; vp3, invasion of (or tumor thrombus in) first order branches of the portal vein; vp4, invasion of (or tumor thrombus in) the main trunk of the portal vein and/or contra‐lateral portal vein branch to the primarily involved lobe; vv0, absence of invasion of (or tumor thrombus in) the hepatic vein; vv1, invasion of (or tumor thrombus in) peripheral branches of the hepatic vein; vv2, invasion of (or tumor thrombus in) the right, middle, or left hepatic vein, the inferior right hepatic vein, or the short hepatic vein; vv3, invasion of (or tumor thrombus in) the inferior vena cava.