臨床外科70巻3号

2015年03月発行

特集 生検材料を手術に活かす 臓器別 癌診療における生検の役割

肝癌—腫瘍生検の臨床的意義と今後の展望

著者： 土谷薫¹ 安井豊¹ 黒崎雅之¹ 泉並木¹

所属機関： ¹武蔵野赤十字病院消化器科

ページ範囲：P.304 - P.309

【ポイント】
◆肝癌において腫瘍生検による播種や出血のリスクは低い．
◆K19陽性肝癌は局所根治術（肝切除・RFA）後の再発や遠隔転移の頻度が高い．
◆低分化型肝癌の場合，肝切除術式の検討がなされるべきである．

参考文献

1）日本肝臓学会（編）：科学的根拠に基づく肝癌診療ガイドライン2013年版，第3版．金原出版，2013

2）European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer：EASL-EORTC clinical practice guidelines：management of hepatocellular carcinoma. J Hepatol 56：908-943, 2012

3）Kudo, M, Matsui O, Arii S, et al：Role of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging in the management of hepatocellular carcinoma：consensus at the Symposium of the 48th Annual Meetingof the Liver Cancer Study Group of Japan. Oncology 84（Suppl 1）：21-27, 2013

4）Tung WC, Huang YJ, Leung SW, et al：Incidence of needle tract seeding and responses of soft tissue metastasis by hepatocellular carcinoma postradiotherapy. Liver Int 27：192-200, 2007

5）Fornari F, Civardi G, Cavanna L, et al：Complications of ultrasonically guided fine-needle abdominal biopsy. Results of a multicenter Italian study and review of the literature. The Cooperative Italian Study Group. Scand J Gastroenterol 24：949-955, 1989

6）Fuks D, Cauchy F, Belghiti J, et al：Preoperative tumour biopsy does not affect the oncologic course of patients with transplantable HCC. J Hepatol 61：589-593, 2014

7）Chen Q, Cheng C, Meng Z, et al：Effectiveness and complications of ultrasound guided fine needle aspiration for primary liver cancer in a Chinese population with serum a-fetoprotein levels ●200 ng/ml - a study based on 4,312 patients. PLoS One 9：e101536, 2014

8）Kim H, Park Y：Role of biopsy sampling for diagnosis of early and progressed hepatocellular carcinoma. Best Pract Res Clin Gastroenterol 28：813-829, 2014

9）Uenishi T, Kubo S, Hirohashi K, et al：Cytokeratin 19 expression in hepatocellular carcinoma predicts early postoperative recurrence. Cancer Sci 94：851-857, 2003

10）Tsuchiya K, Komuta M, Izumi N, et al：Expression of keratin 19 is related to high recurrence of hepatocellular carcinoma after radiofrequency ablation. Oncology 80：278-288, 2011

11）Kim H, Choi GH, Park YN, et al：Human hepatocellular carcinoma with “Stemness”-related marker expression：keratin 19 expression and a poor prognosis. Hepatology 54：1707-1717, 2011

12）Sasaki K, Matsuda M, Watanabe G, et al：The influence of histological differentiation grade on the outcome of liver resection for hepatocellular carcinomas 2 cm or smaller in size. World J Surg, 2014 ［Epub ahead of print］