Hepatocellular carcinoma classification: Difference between revisions
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Cancer of the Liver Italian Program (CLIP) system | Cancer of the Liver Italian Program (CLIP) system is used widely because it is adopted from the original Okuda classification system that involves cirrhosis into account. | ||
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Revision as of 16:25, 28 December 2017
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Hepatocellular carcinoma Microchapters |
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Differentiating Hepatocellular carcinoma from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Hepatocellular carcinoma classification On the Web |
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American Roentgen Ray Society Images of Hepatocellular carcinoma classification |
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Risk calculators and risk factors for Hepatocellular carcinoma classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]
Overview
Hepatocellular carcinoma may be classified according to the histological subtypes. The staging of HCC is based on the TNM staging system.
Classification
- Hepatocellular carcinoma may be classified according to the histological subtypes:[1][2]
- Fibrolamellar carcinoma
- Sarcomatoid HCC
- Undifferentiated carcinoma
- Combined HCC-
cholangiocarcinoma (HCC-CC) - Lymphoepithelioma
- Scirrhous hepatocellular carcinoma (scirrhous HCC)
| Hepatocellular carcinoma | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Fibrolamellar carcinoma | Undifferentiated carcinoma | Sarcomatoid HCC | Combined HCC-CC* | Lymphoepithelioma | Scirrhous HCC | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Abbreviations: Combined HCC-cholangiocarcinoma (HCC-CC)*
Staging
TNM staging system
According to the TNM staging system, there are four stages of hepatocellular carcinoma based on the tumor size, lymph node involvement, and distant metastasis.[3]
Primary tumor
| TX | Primary tumour cannot be assessed |
| T0 | No evidence of primary tumour |
| T1 | A single tumour with no invasion into the blood vessels of the liver |
| T2 | A single tumour with invasion into the blood vessels or multiple tumours, none more than 5 cm in size |
| T3a | Multiple tumours, with any tumour larger than 5 cm |
| T3b | The tumour has grown into either the portal or hepatic vein |
| T4 | The tumour has grown into nearby organs (other than the gallbladder) or the tumour has grown into the layer of tissue that covers the organs in the abdomen (visceral peritoneum) |
Regional lymph node
| NX | Regional lymph nodes cannot be assessed |
| NX | No regional lymph node metastasis |
| NX | Regional lymph node metastasis |
Distance metastasis
| M0 | No distant metastasis |
| M1 | Distant metastasis |
CLIP Staging System
Cancer of the Liver Italian Program (CLIP) system is used widely because it is adopted from the original Okuda classification system that involves cirrhosis into account.
| Points | |||
|---|---|---|---|
| Variable | 0 | 1 | 2 |
| i.Tumor number (%) <50 <50 >50 | Single | Multiple | – |
| Hepatic replacement by tumor | <50 | <50 | >50 |
| ii. Child-Pugh score | A | B | C |
| iii. α Fetoprotein level (ng/mL) | <400 | ≥400 | – |
| iv.Portal vein thrombosis (CT) | No | Yes | – |
| CLIP stages (score = sum of points): CLIP 0, 0 points; CLIP 1, 1 point; CLIP 2, 2 points; CLIP 3, more than 3
points. | |||
References
- ↑ Shafizadeh N, Kakar S (2013). "Hepatocellular Carcinoma: Histologic Subtypes". Surg Pathol Clin. 6 (2): 367–84. doi:10.1016/j.path.2013.03.007. PMID 26838979.
- ↑ Matsuura S, Aishima S, Taguchi K, Asayama Y, Terashi T, Honda H, Tsuneyoshi M (2005). "'Scirrhous' type hepatocellular carcinomas: a special reference to expression of cytokeratin 7 and hepatocyte paraffin 1". Histopathology. 47 (4): 382–90. doi:10.1111/j.1365-2559.2005.02230.x. PMID 16178893.
- ↑ Canadian Cancer Society.http://www.cancer.ca/en/cancer-information/cancer-type/liver/staging/?region=ab