Prognostic impact of vessels encapsulating tumor clusters and macrotrabecular patterns in hepatocellular carcinoma

Jun Akiba; Masamichi Nakayama; Eiji Sadashima; Hironori Kusano; Reiichiro Kondo; Yutaro Mihara; Yoshiki Naito; Shinji Mizuochi; Yuta Yano; Yoshinao Kinjo; Kana Tsutsui; Keiichi Kondo; Hisamune Sakai; Toru Hisaka; Osamu Nakashima; Hirohisa Yano

doi:10.1016/j.prp.2022.154084

Prognostic impact of vessels encapsulating tumor clusters and macrotrabecular patterns in hepatocellular carcinoma

Pathol Res Pract. 2022 Oct:238:154084. doi: 10.1016/j.prp.2022.154084. Epub 2022 Aug 23.

Authors

Jun Akiba¹, Masamichi Nakayama², Eiji Sadashima³, Hironori Kusano⁴, Reiichiro Kondo⁵, Yutaro Mihara⁶, Yoshiki Naito⁷, Shinji Mizuochi⁸, Yuta Yano⁹, Yoshinao Kinjo¹⁰, Kana Tsutsui¹¹, Keiichi Kondo¹², Hisamune Sakai¹³, Toru Hisaka¹⁴, Osamu Nakashima¹⁵, Hirohisa Yano¹⁶

Affiliations

¹ Department of Diagnostic Pathology, Kurume University Hospital, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: akiba@med.kurume-u.ac.jp.
² Department of Pathology, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: nakayama_masamichi@med.kurume-u.ac.jp.
³ Life Science Research Institute, Saga-ken Medical Centre Koseikan, Kase-machi, Oaza, Nakahara 400, Saga 840-8571, Japan. Electronic address: sadashima-eiji@koseikan.jp.
⁴ Department of Pathology, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: kusano_hironori@med.kurume-u.ac.jp.
⁵ Department of Pathology, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: kondou_reiichirou@med.kurume-u.ac.jp.
⁶ Department of Pathology, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: mihara_yuutarou@med.kurume-u.ac.jp.
⁷ Department of Clinical Laboratory Medicine, Kurume University Hospital, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: nyoshiki@med.kurume-u.ac.jp.
⁸ Department of Pathology, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: mizuochi_shinji@med.kurume-u.ac.jp.
⁹ Department of Pathology, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: yano_yuuta@med.kurume-u.ac.jp.
¹⁰ Department of Pathology, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: kinjou_yoshinao@med.kurume-u.ac.jp.
¹¹ Department of Pathology, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: tsutsui_kana@med.kurume-u.ac.jp.
¹² Department of Pathology, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: kondou_keiichi@kurume-u.ac.jp.
¹³ Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: hisamune@med.kurume-u.ac.jp.
¹⁴ Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: thisaka@med.kurume-u.ac.jp.
¹⁵ Department of Clinical Laboratory Medicine, Kurume University Hospital, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: o-nakashima@st-mary-med.or.jp.
¹⁶ Department of Pathology, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan. Electronic address: hiroyano@med.kurume-u.ac.jp.

PMID: 36087415
DOI: 10.1016/j.prp.2022.154084

Abstract

Background: Hepatocellular carcinoma (HCC) shows a high mortality rate. A macrotrabecular (MT) pattern and vessels encapsulating tumor clusters (VETC) pattern have been reported as aggressive histological patterns in HCC. However, their cut-off values have been contentious.

Method: Nine hundred eighty-five cases of previously diagnosed HCC were enrolled. The percentage areas of the MT and/or VETC pattern with ≥ 5% at every 10% increment were assessed. Clinicopathological analysis including patients' prognosis was conducted.

Result: One hundred fifty-eight and eighty-four cases were accompanied by 5-49% and ≥ 50% MT components, respectively. Two hundred six and twenty-nine cases had 5-49% and ≥ 50% VETC components, respectively. Cases with these histological patterns in common had aggressive characteristics and worse prognosis compared to cases with none of these patterns. The presence of 5-49% VETC pattern was independent worse prognostic factor in overall survival (P = 0.046). HCCs with the MT pattern and the VETC pattern were significantly accompanied by the VETC pattern and the MT pattern (P < 0.001), respectively.

Conclusion: As even 5% of the MT pattern and/or VETC pattern affected the prognosis of patients with HCC, the amount of these pattern should be described in pathological reports. This information could be useful in expecting patients' prognosis and providing proper post-operative treatments.

Keywords: Hepatocellular carcinoma; Macrotrabecular pattern; Prognosis; Vessels encapsulating tumor clusters pattern.