PATHOLOGICAL FEATURES OF PATIENTS WITH RESECTED HEPATOCELLULAR CARCINOMA AND LYMPH NODE METASTASIS

Abstract

Intrahepatic metastasis via the portal venous system and bloodborne distant metastasis are common in hepatocellular carcinoma. However, lymph node metastasis after resection of hepatocellularcarcinoma is rare. and recurrence of lymph node metastasis after surgical resection is also rare. On the other hand, detection of lymph node metastasis has been reported in about 30% of autopsy cases. We carried out this clinicopathological study to assess patients positive for lymph node metastasis among those who underwent surgical resection of hepatocellular carcinoma. A total of 951 patients underwent resection of HCC in our department during the period from 1983 to 1995, and 57 of them, the lymph nodes were dissected or the hepatoduodenal liga-ment and superior pancreatic rim alone were sampled intraoperatively because lymph node enlargement was noted during surgery. Histological examination showed lymph node metastasis in 7 patients. The carcinomas were larger than 4cm in diameter in all 7 patients and had invaded other organs in 3 of them. Many metastic lymph nodes were detected in cases 8 and 12. Lymph node metastasis was associated with cirrhosis in one of them. All 7 patients had poorly-differentiated HCC, with extensive interstitial invasion. We analyzed the correlation between lymph node metastasis and levels of carcinoembryonic antigen (CEA), tumor grade and liver tissue. There was a significant correlation between these facters and lymph node metastasis (p<0.05).