COMPUTED TOMOGRAPHIC AND MORPHOLOGICAL COMPARISONSIN HEPATOCELLULAR CARCINOMA AT VARIOUS GRADES OF DIFFERENTIATION

U.N. Tumanova (1), E.A. Dubova (2), G.G. Karmazanovsky (1), A.I. Shchegolev (2)
1 -Federal State Budgetary Institution «Vishnevsky Institute of Surgery» of the Ministry of Healthcare and Social Development of the Russian Federation,
2 -Federal State Budget Institution «Research Center for Obstetrics, Gynecology and Perinatology» of the Ministry of Healthcare and Social Development of the Russian Federation

The Use of the technique of contrast enhancement in spiral computed tomography (SCT) allows us to study the peculiarities of hemodynamics in the tumor tissue and thus facilitates the differential diagnosis. Сomparison of SKT data with the results of morphological study of hepatocellular carcinoma (HCC) at various stages of differentiation. The work is based on the clinical and morphological comparisons performed in 21 patients (13 males and 8 females, aged 18–72 years with HCC without concomitant liver cirrhosis. At the preoperative stage all patients underwent spiral computed tomography (CT) with bolus contrast enhancement (during four phases of the study). In histological preparations of resected HCC tissues with the use of antibodies to CD34 and CD105 by immunohistochemical method blood vessels were detected, and morphometric analysis was performed. In morphological study of histological preparations of operation material from 6 patients well-differentiated variant of HCC, in 12 cases – moderately differentiated, and 3 patients – low differentiated variant of HCC was diagnosed. CT densities of tumors are distinguishable at various stages of histological differentiation and depend on the phase in the CT study. Higher meanings of CT density in HCC HD at the native and venous phase are consistent with larger values of the number and cross-sectional area of blood vessels, identified by ourselves with morphometric study. In immunohistochemical reactions with antibodies to CD105 in tumor tissues the number of revealed blood vessels is less than the number CD34 positive vessels, irrespective of the stage of histological differentiation. The features of the relationship between CT density performance and HCC tissue angioarchitectonics have been revealed with correlation analysis. CT characteristics of HCC depend on the phase of the study, the number of incoming contrast agent and the stage of histological differentiation. Immunohistochemical and morphometric characteristics of the vascular bed are also dependent on the grade of malignant neoplasms.
Keywords: 
hepatocellular carcinoma, immunohistochemistry, density, computed tomography, morphometry, blood vessels