2019 年世界卫生组织(World Health Organization,WHO)发布的第五版《消化系统肿瘤分类》将肝细胞癌(hepatocellular carcinoma,HCC)组织学亚型分为粗梁-团块型、脂肪性肝炎样型、纤维板层型、硬化型、透明细胞型、嫌色细胞型、富含淋巴细胞型、富含中性粒细胞型8种.不同亚型HCC因其组织病理特征有所差异,表现出不同的影像学特征.然而,国内外关于各亚型的影像表现研究较少,临床基于组织病理学亚型的治疗建议尚未明确.基于此,本文归纳总结了已报道的HCC各亚型相关影像表现及病理特征,探讨现存之局限、未来之挑战,以期为增加HCC各亚型了解、明确治疗策略的选择提供更多理论依据.
Advances in imaging features of histological subtypes of hepatocellular carcinoma
In the fifth edition of the Classification of Digestive System Tumors released by the World Health Organization in 2019,the histological subtypes of hepatocellular carcinoma were divided into eight types:coarse beam-mass type,steatohepatitis type,fibrolaminoid type,sclerotic type,clear cell type,chromophobe type,lymphocyte-rich type and neutrophil-rich type.Different subtypes of hepatocellular carcinoma show different imaging features due to their histopathologic characteristics.However,there are few studies on the imaging manifestations of each subtype at home and abroad,and the clinical treatment recommendations based on histopathological subtypes are not clear.Based on this,this paper summarized the reported imaging findings and pathological features of each subtype of hepatocellular carcinoma,and discussed the existing limitations and future challenges,in order to provide more theoretical basis for improving the understanding of each subtype of hepatocellular carcinoma and clarifying the choice of treatment strategies.