Biomedical subjects

K Shirabe

Publications and source records attributed to K Shirabe.

At least 145 records · Page 8Linked to original sources

PubMedDate not supplied

Cell proliferation and cell loss in nodule-in-nodule hepatocellular carcinoma.

BACKGROUND/AIMS: In order to clarify the significance of the balance between cell proliferation and cell loss during the progression of hepatocellular carcinoma, 16 operative specimens of nodule-in-nodule hepatocellular carcinoma were investigated. METHODOLOGY: In 16 specimens, cell proliferation was evaluated by the expression of Ki-67 nuclear antigen, and cell loss was also examined by the method of terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL). The expressions of p53 protein, bcl-2 protein and Fas antigen were also investigated to clarify the relationship between their expression and cell kinetics. RESULTS: The Ki-67 labeling index of the inner nodules was higher than that for the outer nodules (18.9% vs. 7.2%; p < 0.05) and the TUNEL labeling index of the inner nodules was also higher than that for the outer nodules (12.8% vs. 6.6%; p < 0.05). The increasing rate of the Ki-67 labeling index from Edmondson's grade I to II was 3.9 +/- 3.0, that from grade II to III was 3.9 +/- 2.4, while the increasing rate of the TUNEL labeling index from grade I to II was 2.7 +/- 0.3 and that from grade II to III was 1.7 +/- 0.2 (p < 0.05). p53 Protein was observed in 5 cases, while bcl-2 protein was found in 4 cases in the border area of the inner nodule. However, Fas antigen was found in none of the examined cases. Regarding the Ki-67 positive rate in the inner nodule, the Ki-67 positive rate in the p53 protein positive cases was significantly higher than that in the negative cases (30.3 +/- 15.4 vs. 11.9 +/- 9.2; p < 0.05). However, the TUNEL labeling index was not affected by the expression of those proteins. CONCLUSIONS: This study suggested that tumor progression depends on a disturbance in the cell kinetic balance caused not by a decrease in the absolute amount of cell loss but in the chaotic balance between cell loss and cell proliferation.

Apoptosis↗

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Risk factors of the recurrence of hepatocellular carcinoma originating from residual cancer cells after hepatectomy.

BACKGROUND/AIMS: Little has been documented to differentiate between recurrence originating from microscopic residual tumor cells and recurrence due to metachronous multicentric origin of hepatocellular carcinoma (HCC). The aim of this study was to clarify the risk factors of HCC recurrence closely related to residual tumor cells. METHODOLOGY: A retrospective review of hepatic resections for HCC during the period between April 1985 and April 1997 was undertaken at a University Hospital with a long history of hepatectomy for HCC. Three hundred and thirteen HCC patients without any definite multicentric recurrence, who underwent hepatectomy, were retrospectively investigated. Main outcome measures were: (Study 1) Risk factors for recurrence were univariately and multivariately investigated among various clinicopathological variables, including the vi factor as a new indicator of the potential malignancy of HCC (i.e., the presence of both microscopic portal vein invasion and intrahepatic metastasis). (Study 2). The risk factors for recurrence were then analyzed according to the period of recurrence. RESULTS: (Study 1) Independent risk factors were: (tumor factors) a positive vi factor, alpha-fetoprotein > 100 ng/ml, and poorly differentiated histology; (host factors) albumin < 3.8 g/dl, the presence of diabetes mellitus, platelet count < 14 x 10(4)/microliter, Y-globulin fraction > 20%. In those risk factors, the relative risk of the vi factor (2.6) was the largest. (Study 2) Within 1 year after hepatectomy, only tumor factors, including the vi factor and poorly differentiated histology, were significant risk factors, tumor factors were significant only up to 2 years after hepatectomy, and thereafter only host factors were significant. CONCLUSIONS: The risk factors for non-multicentric recurrence of HCC are considered to be a positive vi factor, alpha-fetoprotein, and poorly differentiated histology, and the vi factor is considered to be a new prognostic indicator expressing the potential malignancy of HCC such as invasion and metastasis.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Clinicopathological characteristics of surgically resected minute hepatocellular carcinomas.

BACKGROUND/AIMS: The multistep development of overt hepatocellular carcinoma from very well-differentiated early hepatocellular carcinoma, and of early hepatocellular carcinoma from adenomatous hyperplasia has been strongly suggested. The clinicopathologic and immunohistochemical characteristics of solitary minute hepatocellular carcinomas smaller than 1 cm in size have yet to be clarified. METHODOLOGY: Fourteen minute hepatocellular carcinomas were divided into 2 groups consisting of: 1) hepatocellular carcinoma of hepatitis B surface antigen positive patients (B-HCC) (n = 5), and 2) hepatocellular carcinoma of hepatitis C virus antibody positive patients (C-HCC) (n = 9), then they were all analyzed histopathologically and clinicopathologically. Immunohistochemical studies were also performed using the antibodies against p53 protein. RESULTS: Six of the 14 minute hepatocellular carcinoma were demonstrated to be moderately or poorly differentiated tumors. Among the 8 well-differentiated minute hepatocellular carcinomas, 2 tumors already contained less differentiated components. B-HCC tended to be less differentiated than C-HCC (P < 0.05). Adenomatous hyperplasia was detected in only 2 cases of C-HCC. Small cell liver dysplasia was detected significantly more frequently in C-HCC than in B-HCC (P < 0.05). The prognosis of the 14 minute hepatocellular carcinomas varied considerably. Immunohistochemically, some tumor cells were positive for p53 in 3 cases. CONCLUSIONS: Our study suggests that 1) the multistep carcinogenesis through adenomatous hyperplasia may not be so frequent, 2) De novo carcinogenesis from not only well-differentiated hepatocellular carcinoma, but also from less differentiated hepatocellular carcinoma, especially B-HCC, may be present, 3) the carcinogenesis in the B-HCC cases may behave differently from that in C-HCC cases, and 4) minute hepatocellular carcinomas demonstrate varying prognoses after hepatectomy.

Adult↗

PubMedDate not supplied

Antitumor effects of soybean hypocotyls and soybeans on the mammary tumor induction by N-methyl-n-nitrosourea in F344 rats.

BACKGROUND: Soybeans are reported to have cancer inhibitory effects, probably due to their isoflavones. Soybean hypocotyls are embryo buds of soybeans and contain a higher amount of isoflavones and other factors than soybeans themselves. MATERIALS AND METHODS: The effects of soybean protein and soybean hypocotyls as diets on the development of N-methyl-n-nitrosourea (MNU) induced tumors were examined in female F344 rats. For this trial, 120 animals were used and at 6 weeks of age, groups of 30 animals were fed diets containing casein, soy protein isolate (SPI), 1.5% soybean hypocotyls and 5% soybean hypocotyls. Three weeks later all the animals except the control animals received a first dose (37.5 mg/kg body weight) of MNU by tail vein injection. At 29 weeks of age the animals received a second MNU dose (50 mg/kg body weight). Testing was performed 42 weeks after the first MNU dose. RESULTS: Analysis of cumulative palpable tumor incidence indicated that final tumor development of the SPI diet group and the hypocotyl diet groups was less than that of the casein diet group. Tumors were detected in one or more sites from 9 out of 24 rats in the casein diet group, 5 of 20 rats in SPI diet group, 6 out of 24 rats in the 1.5% hypocotyl diet group and 6 out of 23 rats in the 5% hypocotyl diet group. Pairwise comparisons indicated that the formation of tumors during the experiment was significantly less rapid in the SPI diet group and the hypocotyl diet groups than the casein group. No difference in tumor promotion was observed between the SPI diet group and the soybean hypocotyl diet groups. CONCLUSION: Our results suggest that dietary soybeans and soybean hypocotyls are capable of suppressing tumor promotion.

Animals↗

PubMedDate not supplied

Characteristics of sarcomatous cholangiocarcinoma of the liver.

BACKGROUND/AIMS: The aim of this study was to clarify the clinicopathological characteristics of intrahepatic cholangiocarcinoma with sarcomatous changes. METHODOLOGY: Four cases of cholangiocarcinoma with sarcomatous change were identified and investigated. The clinicopathological findings, including the results of immunohistochemical staining, were investigated in comparison with those of ordinary cholangiocarcinoma. RESULTS: Two of them exhibited pyrexia as the initial symptom. The serum alkaline phosphatase level in sarcomatous cholangiocarcinoma was significantly lower than that in ordinary cholangiocarcinoma. Both the serum carcinoembryonic antigen and carbohydrate 19-9 level in sarcomatous cholangiocarcinoma also tended to be lower than those in ordinary cholangiocarcinoma. The carcinomatous component of all tumors was mostly poorly differentiated adenocarcinoma. The associated microscopic findings were as follows: lymphocyte infiltration in the tumor, accompanied by both necrosis and extensive lymph node metastases. Three of them predominantly exhibited spindle-shaped sarcomatous changes, whereas the other case predominantly demonstrated pleomorphic-type sarcomatous changes. The sarcomatous area was positive for both vimentin, a mesenchymal marker, and for epithelial markers, furthermore, in 3 of 4 cases, the carcinoma portions were also positive for vimentin. The overall survival curves were not significantly different between the 2 groups, however, no long-term survivor was found in sarcomatous cholangiocarcinoma. CONCLUSIONS: The main characteristics of cholangiocarcinoma with sarcomatous changes are considered to be as follows: 1) often demonstrating pyrexia as a symptom; 2) not always demonstrating remarkable abnormal findings in the laboratory data including tumor markers; 3) histologically showing poorly differentiated adenocarcinoma; and 4) showing a very poor prognosis (especially, in a pleomorphic-type).

Aged↗

PubMedDate not supplied

Small hepatocellular carcinoma with minute satellite nodules.

BACKGROUND/AIMS: To investigate the clinicopathologic characteristics of small hepatocellular carcinoma with minute satellite nodules. METHODOLOGY: We investigated the clinicopathologic characteristics of 131 solitary small (< or = 2.0 cm in diameter) hepatocellular carcinomas including 105 hepatocellular carcinomas without minute satellite nodules and 17 hepatocellular carcinomas with minute satellite nodules smaller than 5 mm, and also discuss the clinical significance. RESULTS: None of the clinical backgrounds of the patients and pathologic features of the main tumor, except for the average of preoperative serum alpha-fetoprotein, were significantly different between the two groups. Firstly, minute satellite nodules demonstrated that the maximum diameter of all minute satellite nodules was 1.5-4.0 mm, secondly, the moderately to poorly differentiated hepatocellular carcinomas had 4 or more minute satellite nodules within 1 cm from the main tumor, while well differentiated hepatocellular carcinomas may have 1 or 2 minute satellite nodules 6 cm or more away, and thirdly, 4 or more minute satellite nodules may present within 1 cm in intrahepatic metastasis cases, while 1 or 2 minute satellite nodules may be present 6 cm or more away from the main tumor in multicentric occurrence cases. CONCLUSIONS: At least 13% of solitary small hepatocellular carcinomas had preoperatively undetectable minute satellite nodules. In case of moderately to poorly differentiated hepatocellular carcinomas, hepatic resection as well as percutaneous ethanol injection should be performed including the surrounding liver tissue at least 1.0 cm from the main nodule. On the other hand, in well-differentiated hepatocellular carcinomas, which may indicate multicentric occurrence, closer observation and careful follow-up after therapy are recommended.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Surgical indications for advanced hepatocellular carcinoma.

BACKGROUND/AIMS: The aim of this study is to clarify the limitations of hepatectomy for advanced hepatocellular carcinoma. METHODOLOGY: Fifty-six patients with Stage 4 hepatocellular carcinoma were retrospectively studied, and the prognostic factors were both univariately and multivariately analyzed. The VI score, which was defined as the degree of portal vein invasion (VP) multiplied by the degree of intrahepatic metastases (IM), was introduced as a new prognostic indicator. RESULTS: A univariate analysis revealed the following significant variables: hypertension, esophageal varices, Child's classification B or C, a bilirubin value of over 1.0 mg/dL, a albumin value of below 3.5 g/dL, a GOT value of over 100 IU/L, an AFP value of over 1000 ng/mL, a history of tumor rupture, Stage 4B, a tumor size of over 5 cm, VP3, IM3, and the VI score of no less than 6. A multivariate analysis demonstrated the following 4 variables to be independent prognostic indicators: a Stage of 4B, a VI score of no less than 6, a Child's classification of B or C, and a tumor size of over 5 cm. Furthermore, no long-term survivors were found in patients with either Stage 4B HCC or a hepatocellular carcinoma having a VI score of more than 6. At the present time, either Stage 4B or a hepatocellular carcinoma having a VI score > or = 6 are considered to be factors which means the limitation of hepatectomy alone. Furthermore, an advanced hepatocellular carcinoma with either poor liver function or a hepatocellular carcinoma with a size of over 5 cm should be carefully evaluated before determining its appropriateness for hepatectomy. CONCLUSIONS: The VI score is therefore suggested to be a useful prognostic indicator for determining the surgical indications for advanced hepatocellular carcinomas.

Adult↗

PubMedDate not supplied

Clinicopathological characteristics of patients with extrahepatic recurrence following a hepatectomy for hepatocellular carcinoma.

BACKGROUND/AIMS: None of the previous studies have compared the prognosis or clinicopathological factors between the patients with extrahepatic recurrence and those with intrahepatic recurrence of hepatocellular carcinoma after a hepatic resection. METHODOLOGY: The clinicopathological features and prognoses of patients with extrahepatic recurrence after a curative hepatectomy for hepatocellular carcinoma were investigated. RESULTS: Twenty-three patients with extrahepatic recurrence had more advanced-stage hepatocellular carcinoma at the primary operation compared to 186 patients with intrahepatic recurrence. After adjusting for tumor size, the prognosis of the 2 groups were comparable. However, among the patients with hepatocellular carcinoma exceeding 5 cm in diameter, the number of patients whose plasma levels of des-gamma-carboxy prothrombin was higher than 2.0 AU/mL in the patients with extrahepatic recurrence (62.5%) was significantly more (P < 0.05) than that in the patients with intrahepatic recurrence (20.0%). On the other hand, the prognosis of the 13 patients with extrahepatic recurrence alone was significantly better than in the 10 patients with both intrahepatic and extrahepatic recurrences. The prognoses of the 3 patients who underwent a surgical resection for isolated extrahepatic recurrence were markedly better than that of the remaining 10 patients only treated palliatively. CONCLUSIONS: If patients have tumors exceeding 5 cm in diameter and their plasma levels of des-gamma-carboxy prothrombin are higher than 2.0 AU/mL, more careful follow-up examinations than usual may thus be necessary in order to detect extrahepatic recurrence as early as possible. Furthermore, a surgical resection for the isolated extrahepatic recurrence of hepatocellular carcinoma is also recommended to produce long-term survivors.

Adult↗

PubMedDate not supplied

Thrombectomy before hepatic resection for hepatocellular carcinoma with a tumor thrombus extending to the inferior vena cava.

Tumor thrombi of hepatocellular carcinoma occasionally invade into the inferior vena cava (IVC) through the hepatic vein. Once the tumor thrombus is dislodged, severe and lethal complications, such as pulmonary infarction, can develop. We successfully operated on a hepatocellular carcinoma (HCC) patient with a tumor thrombus extending to the IVC through the right hepatic vein. To avoid dislodging the thrombus during surgery, a thrombectomy using selective hepatic vascular exclusion was performed before a hepatic resection, which is the most dangerous procedure to dislodge the thrombus.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Strategies for intractable ascites after hepatic resection: analysis of two cases.

Intractable ascites after hepatic resection is one of the gravest complications pertaining to deterioration in a patient's quality of life. Two cases are presented with intractable ascites that did not respond to ordinary conservative treatment after hepatic resection but were eventually successfully treated. The authors propose the following strategies: the conducting of aggressive and extensive examinations including angiography; and a peritoneovenous shunt for patients demonstrating no definite cause, to improve their quality of life.

Ascites↗

PubMedDate not supplied

A refined method of trans-thoracoabdominal hepatectomy for cirrhotic patients with hepatocellular carcinoma.

A hepatectomy in cirrhotic patients with hepatocellular carcinoma, located in either the posterior or superior part of the right lobe, inevitably requires a forced mobilization of the right lobe. Such a forced procedure causes a decreased hepatic blood flow resulting in postoperative morbidity and mortality, as well as an increased risk of the intrahepatic dissemination of cancer cells during the operation. We have thus refined the method of trans-thoracoabdominal hepatectomy to minimize those demerits of conventional transabdominal hepatectomies. The main characteristics of our refinements are as follows; (1) an optimal incision for the best short-cut to the hepatocellular carcinoma is determined by a three-dimensional imaging of either helical computed tomography and/or magnetic resonance imaging before operation; (2) a complete view of the operative field is obtained by the pertinent use of rotating the operation table, on which the patient is placed in a left semi-lateral position; (3) this method is suitable for resecting a tumor located in the posterior segment such as a posterior segmentectomy. This refined method is considered to decrease the postoperative morbidity including post-operative hepatic dysfunction and is also useful for cirrhotic patients with hepatocellular carcinoma.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Morbidity and mortality after hepatic resection in the modern era.

BACKGROUND/AIMS: The purpose of this study was to clarify the risk factors associated with complications following hepatic resections and discuss the appropriate types of perioperative management. MATERIALS AND METHODS: A retrospective analysis was made of the complications in 355 patients undergoing hepatic resection between April 1985 and August 1992 at the Second Department of Surgery, Kyushu University Hospital. The patients were placed in two groups according to the occurrence of complications: patients with morbidity and/or mortality (187 patients); patients without either morbidity or mortality (168 patients). RESULTS: The leading complications were the accumulation of fluid in the abdominal and pleural cavities along with septic complications. The only significant factory affecting morbidity and mortality among the preoperative medical conditions was the presence of diabetes while, in addition, the patients with morbidity and/or mortality had higher levels of perioperative transaminase and serum creatinine as compared with those in patients without either morbidity or mortality. CONCLUSIONS: The perioperative strategies for reducing morbidity include the strict control of diabetes to reduce septic complications as well as preserve renal function, which can protect against the refractory accumulation of fluid in the peritoneal and pleural cavities.

Adult↗

PubMedDate not supplied

Surgical results of spontaneously ruptured hepatocellular carcinoma.

Seventeen patients with ruptured hepatocellular carcinoma (HCC) underwent a hepatic resection from 1985 to 1992 at either Kyushu University Hospital or Iizuka Hospital in Japan. They all underwent elective surgical procedures except for one patient who experienced a repeated rupture during hospitalization. A comparative study between the patients with ruptured HCC and non-ruptured large HCC measuring more than 6 cm in size (n = 29) revealed that the 3-year disease-free survival rate of the ruptured HCC group was 14.5% which was worse than that of the non-ruptured group at 39.9%. There was no difference in the rates of peritoneal dissemination, distant metastasis or intrahepatic recurrence between the two groups. Regarding the intrahepatic recurrence pattern, widespread multinodular recurrence frequently occured in the ruptured patients, which was thought to be caused by the high incidence of venous invasion in the primary tumor. The intratumor pressure of the ruptured HCC appeared to be elevated and is considered to be one of the main reasons for the high incidence of venous invasion.

Adult↗

PubMedDate not supplied

The role of interleukin-6, interleukin-16, tumor necrosis factor-alpha and endotoxin in hepatic resection.

BACKGROUND/AIMS: The role of cytokines was investigated in patients undergoing hepatic resection. MATERIALS AND METHODS: Cytokines such as interleukin-16, interleukin-6 and tumor necrosis factor-alpha were serially measured both before and after hepatic resection. RESULTS: The levels of interleukin-16 and interleukin-6 increased immediately after operation, while that of tumor necrosis factor-alpha was only slightly elevated. The increase in interleukin-6 was more prominent than that in interleukin-16. The level of urinary polyamine was elevated at postoperative day 1, while the level of C-reactive protein reached a peak at postoperative day 3. Moreover, no endotoxin in either the peripheral or portal vein was ever detected in this series. Regarding the comparison between major (more than 2 segments) and minor (less than 1 segment) resections, no significant difference was found in the levels of interleukin-1 beta, interleukin-6 or urinary polyamine. CONCLUSIONS: Therefore, interleukin-6 is considered to be a more sensitive marker of surgical stress than interleukin-1 beta and CRP, while both interleukin-6 and interleukin-16 are suggested to induce hepatic regeneration and the production of acute phase protein in the liver. Furthermore, the absence of any correlation between the volume resected and those cytokine levels suggests that some other as yet unidentified mechanism could be also related to the regulation of hepatic regeneration.

Aged↗

PubMedDate not supplied

The role of prostanoid in hepatic damage during hepatectomy.

BACKGROUND/AIMS: The aim of this study in hepatectomy is to investigate whether or not hepatic ischemia elevates the serum prostanoid levels, and whether or not thromboxane A2 (TXA2) synthetase inhibitor (OKY 046) improves hepatic damage. MATERIALS AND METHODS: The prostanoid levels were measured in 22 hepatectomy cases. The beneficial effects of thromboxane A2 synthetase inhibitor were examined in cases who underwent hepatectomy under hemihepatic vascular control. The total prostanoid levels (6-keto PG Fla+ PGE2 + TXB2) were measured in 22 cases before and after hepatectomy. The hepatic ischemic time (HIT) was defined as the time required to perform a hepatic mobilization plus the right hemihepatic vascular control technique. RESULTS: The total prostanoid levels increased after hepatectomy (P < 0.01). The changes in the total prostanoid levels positively correlated with the HIT (P < 0.01). The 17 cases who underwent hepatectomy with the HIT were randomly divided into 2 groups; the OKY group (n = 9), OKY 046 (0.2 mg/kg/hr), the control group (n = 8); no drug was given. The OKY 046 administration reduced the TXB2 levels (P < 0.01), without any changes in the PGE2, or 6-keto PGF1a levels. The serum glutamic oxaloacetic transaminase levels after operation were lower, and the hepaplastin tests were higher in the OKY group than those of the control (P < 0.05). CONCLUSION: These results demonstrated that hepatectomy under ischemia elevated the prostanoid levels. OKY 046 significantly reduced the TXB2 levels and the degree of hepatic damage in hepatectomy under ischemia.

Aspartate Aminotransferases↗

PubMedDate not supplied

Nutritional support after hepatic resection: a randomized prospective study.

BACKGROUND: A consensus as to whether hypertonic dextrose should be given to patients with chronic liver diseases such as cirrhosis or chronic hepatitis after major hepatectomy has not been reached, mostly because metabolism in the remnant liver switches from utilization of blood glucose to utilization predominantly of fatty acid as an energy source. We investigated whether nutritional support would have beneficial effects for such patients. PATIENTS AND METHODS: Among 19 patients, 10 were given peripheral dextrose (10 kcal/kg/day) for seven days following hepatectomy and the other 9 were given hypertonic glucose. Twenty and 30 kcal/kg/day was the average non-protein caloric intake, including free oral intake during the first one week following hepatectomy, respectively. RESULTS: The groups were comparable with regard to laboratory data and operative stress. There were no untoward effects related to this support. In patients given nutritional support, retinol binding protein and prealbumin improved (p < 0.05 and p < 0.05, respectively), urinary 3-methylhistidine excretion decreased (p < 0.01) and the nitrogen balance normalized earlier (p < 0.05), as compared to findings with the conventional method. CONCLUSION: The remnant liver can utilize dextrose and nutritional support improves the nutritional status and may even preserve muscle protein mass.

Amino Acids, Branched-Chain↗

PubMedDate not supplied

Surgically resected primary malignant lymphoma of the liver.

Primary malignant lymphoma of the liver is extremely rare, and its preoperative or even premortem diagnosis is still difficult. The authors herein report a case of primary malignant lymphoma of the liver in a 51-year-old Japanese man. The findings at angiography were non-specific, but a hypoechoic mass with a halo was demonstrated by ultrasound sonography, which revealed rapid progression. The tumor volume doubling time was 9.6 days. An extended right hepatic lobectomy with lymph nodes dissection was done on the basis of a preoperative diagnosis of hepatocellular carcinoma, while the diagnosis based on immunohistological studies was T cell malignant lymphoma of the liver. After the adjuvant chemotherapy, the patient continues to be free of disease for three years and nine months. We herein describe the optimum methodology for making a preoperative diagnosis of primary malignant lymphoma of the liver. We also consider that a curative hepatic resection with adjuvant chemotherapy for primary malignant lymphoma of the liver is an adequate treatment for this disease.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

A primary adenosquamous carcinoma of the liver with an elevated level of serum squamous cell carcinoma related antigen.

A case of primary adenosquamous carcinoma of the liver with an elevated level of serum squamous cell carcinoma related antigen is herein reported. Various hypotheses on the pathogenesis of adenosquamous carcinoma of the liver have been set forth previously, however there is still no widely accepted theory because of the absence of any sufficient evidence. The postoperative transition of serum squamous cell carcinoma related antigen and the immunohistochemical findings using anti-involucrin antigen in this case support the hypothesis that the squamous cell carcinoma component arises as a result of the metaplastic transformation of adenocarcinoma cells.

Aged↗