Histopathological and immunohistochemical study of precancerous lesions and hepatocellular carcinoma

MINISTRY OF EDUCATION AND TRAINING MINISTRY OF HEALTH HANOI MEDICAL UNIVERSITY

TRAN NGOC MINH

Histopathological and immunohistochemical studies of lesions

Precancer and Hepatocellular Carcinoma

DOCTORAL THESIS IN MEDICINE

HANOI - 2020

MINISTRY OF EDUCATION AND TRAINING MINISTRY OF HEALTH HANOI MEDICAL UNIVERSITY

TRAN NGOC MINH

Histopathological and immunohistochemical studies of lesions

Precancer and Hepatocellular Carcinoma

Industry: Pathology and Forensic Medicine Code: 62720105

DOCTORAL THESIS IN MEDICINE

Scientific instructor:

Assoc.Prof.Dr. Nguyen Van Hung

HANOI - 2020

ACKNOWLEDGEMENTS

I would like to sincerely thank the Party Committee, the Board of Directors, the Postgraduate Training Department, and the Department of Pathology, Hanoi Medical University for creating favorable conditions and wholeheartedly helping me during my study and research.

I would like to sincerely thank the Board of Directors, the General Planning Department, the Department of Pathology - Hanoi Medical University Hospital, Hanoi Oncology Hospital, Viet Duc Hospital and the Center for Pathology - Cytology of Bach Mai Hospital for creating favorable conditions for me to complete my research.

I would like to express my deep gratitude to my supervisor - Associate Professor, Dr. Nguyen Van Hung - who has wholeheartedly guided and helped me throughout my studies and research, and who was also the first teacher to guide me to study Pathological Anatomy, who discovered and gave me ideas, inspiration and passion when delving into this field of research.

I would like to sincerely thank my beloved teachers, colleagues in the Department of Pathology, especially Dr. Nguyen Thuy Huong, who has imparted knowledge, always guided, helped and created favorable conditions for me in my studies as well as in my daily work.

I would like to express my gratitude for the enthusiastic help of the teachers, staff of the Department of Pathology - Hanoi Medical University Hospital, where I work and research every day, who have wholeheartedly helped me complete this thesis.

I would like to sincerely thank my colleagues who have enthusiastically helped, discussed and cooperated with me in professional work and scientific research so that today I can complete this thesis.

I would like to express my gratitude to the patients who contributed and supported me in completing this research.

Finally, I would like to express my deep gratitude to my family - my Father, Mother, Wife, children, relatives and friends who have always been by my side, given me boundless love and supported me throughout the process of doing this topic.

Hanoi, December 2020

Author

Tran Ngoc Minh

COMMITMENT

I am Tran Ngoc Minh, a graduate student of the 31st course at Hanoi Medical University, majoring in Pathological Anatomy and Forensic Medicine, and I hereby declare that:

1. This is a thesis that I directly conducted under the guidance of Associate Professor, Dr. Nguyen Van Hung.

2. This work does not overlap with any other research published in Vietnam.

3. The data and information in the study are completely accurate, honest and objective, and have been confirmed and approved by the research facility.

I take full legal responsibility for these commitments.

Hanoi, December 2020

Author

Tran Ngoc Minh

ABBREVIATIONS

AASLD

American Association for the Study of Liver Diseases (American Liver Association)
AFP	Alpha Fetoprotein
APASL	Asian Pacific Association for the Study of Liver (Asia Pacific Liver Society)
Arg-1	Arginase-1
B-HCA	β-catenin-mutated HCA – Hepatocellular adenoma Beta-catenin
BN BĐTBL Real Estate	Patient Large cell transformation Small cell transformation
CDHA	Diagnostic imaging
CHT	Magnetic resonance
CLVT	CT scan
EASL	European Association for the Study of the Liver (European Liver Society)
FNA	(Fine Needle Aspiration) - Fine Needle Aspiration
GPB	Pathology
GPC-3	Glypican-3
GS	Glutamine Synthetase
HepPar-1	Hepatocyte Paraffin-1
H-HCA	Hepatocyte nuclear factor 1 α-mutated HCA – Hepatocyte cell adenoma Hepatic factor 1α mutation in hepatocytes.
HMD	Immunohistochemistry
HSP-70	Heat shock protein – 70 – Heat shock protein 70.

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I-HCA

Inflammatory HCA- Hepatocellular adenoma
JSH	(Japan Society of Hepatology) - Japan Society of Hepatology
L-FABP	Liver fatty acid binding protein (Liver fatty acid binding protein)
MBH	Histopathology
NC	Study
NLS	Dysplastic nodule
PAS	Periodic Acid Shiff
pCEA QSNKT	Polyclonal Carcinoembryonic Antigen Focal nodular hyperplasia
SAA	Serum Amyloid A – Serum Amyloid A Protein
SIR	Society of Interventional Radiology (Interventional Radiology Society)
TERT	Telomarase reverse transcriptase
TNM	Classification T, N, M
U-HCA	Unclassified HCA – Hepatocellular adenoma, unclassified
UTBM	Carcinoma
UTBMTBG	Hepatocellular carcinoma
UTG	Liver cancer
UTKNT	Neuroendocrine tumors
UTTBG	Hepatocellular adenoma
VGB	Hepatitis B
VGC	Hepatitis C