ĐẶC ĐIỂM GIẢI PHẪU BỆNH UNG THƯ BIỂU MÔ TẾ BÀO GAN Ở BỆNH NHÂN PHẪU THUẬT CẮT GAN TẠI BỆNH VIỆN BẠCH MAI

Abstract

Objective: To describe the pathological characteristics of hepatocellular carcinoma (HCC) after curative surgery. Participants and

Methods: A retrospective cross-sectional descriptive study was conducted on 84 HCC patients who underwent curative resection at the Department of Gastrointestinal - Hepatobiliary Pancreatic Surgery, Bach Mai Hospital, from October 2020 to May 2022.

Results: The majority of patients had a single tumor (92.9%); the mean tumor size was 4.5 cm; 100% of the resection margins were negative, with 42.5% having a margin ≥1 cm. Satellite nodules were present in 20.2% of tumors. The overall rate of vascular invasion was 28.6%, of which the rate of microvascular invasion (MiVI) was quite high at 25%, while macrovascular invasion accounted for only 7.1%. Bile duct invasion was rare (2.4%); 15.5% of tumors showed capsular invasion. Most HCC cases developed on a background of cirrhosis (76.2%). Differentiation grade was significantly associated with the incidence of satellite nodules. The rate of satellite nodules was 54.5% for poorly differentiated HCC, 16.2% for moderately differentiated, and 0% for well-differentiated tumors (p<0.001). Differentiation grade and the presence of satellite nodules were also significantly correlated with the rate of microvascular invasion. The trend of macrovascular invasion was higher in the group with poorly differentiated HCC, large tumors (>5 cm), and cases with satellite nodules, but the difference was not statistically significant.

Conclusion: Hepatocellular carcinoma cases undergoing curative resection at Bach Mai Hospital are primarily solitary tumors, with size <5 cm, and developed on a background of cirrhosis. Poor prognostic factors such as satellite nodules and microvascular invasion are present at a significant rate and are closely correlated with poor tumor differentiation.