Summary
It has been clarified that tumor proliferation is closely related to tumor cell dedifferentiation in hepatocellular carcinoma (HCC) at the early stage. Most small HCCs at the early stage consist solely of well-differentiated cancerous tissues and retain portal tracts inside. In the process of dedifferentiation, less-defferentiated HCC tissues generate in well-differentiated HCCs and they often show a “nodule-in-nodule” appearance, with a clear boundary, when less-differentiated HCC tissue is proliferating in an expansive fashion. Clinically, such a “nodule-in-nodule” appearance is easily appreciated by the examination of imagines. The areas of less-differentiated cancerous tissues inside the well-differentiated HCCs increase in size along with increases in tumor size, and, eventually, well-differentiated tumor nodules are completely replaced by less-differentiated cancerous tissues when the tumors reach around 3.0 cm in diameter. Thus, a “nodule-in-nodule” appearance is regarded as the morphologic marker of the multistep progression of tumor dedifferentiation in HCC, and various factors, such as p53, transforming growth factor (TGF)-α cyclooxygenase (COX)-2, vascular endothelial growth factor (VEGF), and others seem to be involved in the dedifferentiation process.
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Kojiro, M. (2004). Dedifferentiation and Proliferation of Hepatocellular Carcinoma: From Early to Advanced. In: Okita, K. (eds) Stem Cell and Liver Regeneration. Springer, Tokyo. https://doi.org/10.1007/978-4-431-53971-1_8
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DOI: https://doi.org/10.1007/978-4-431-53971-1_8
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