Mechanism of Spontaneous Rupture of Hepatocellular Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

L Chengchao , ZHU Lixin.

Department of Surgery, The First Affiliated Hospital, Anhui Medical University, Hefei 230022, China;

Corresponding author：

Keywords：

Hepatocellular carcinoma Spontaneous rupture Antigen-antibody complex Mechanism

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【Abstract】ObjectiveTo study the mechanism of spontaneous rupture of hepatocellular carcinoma (HCC).
MethodsArticles have been reviewed to find out the
theory of spontaneous rupture of HCC.
ResultsResearchful results suggested that the injury of small arteries was usually followed in patients of spontaneous rupture of HCC. In this review, the immune complex, which composed of hepatitis B virus e antigen, complement C1q and immunoglobulins, was found deposited in the elastic membrane of arteries. Likely as a result of immune complex deposition, vascular injury occurs mainly in the small arteries where the deposition of immune complex was present. The small arteries in which immune complex deposited are readily injuried and cause hemorrhage and rupture of HCC during vascular load increase.
ConclusionWe would conclude that immune complex deposition in vessel wall led to the small arteries injury may be the factor involved in the pathogenesis of spontaneous ruptured HCC.

Citation： L Chengchao,ZHU Lixin.. Mechanism of Spontaneous Rupture of Hepatocellular Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2006, 13(2): 181-183. doi: Copy

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2.	Chearanai O, Plengvanit U, Asavanich C, et al. Spontaneous rupture of primary hepatoma: report of 63 cases with particular reference to the pathogenesis and rationale treatment by hepatic artery ligation [J]. Cancer， 1983; 51(8)∶1532.
3.	Kew MC, Hodkinson J. Rupture of hepatocellular carcinoma as a result of blunt abdominal trauma [J]. Am J Gastroenterol， 1991; 86(8)∶1083.
4.	Hermann RE, David TE. Spontaneous rupture of the liver caused by hepatomas [J]. Surgery， 1973; 74(5)∶715.
5.	Kanematsu M, Imaeda T, Yamawaki Y, et al. Rupture of hepatocellular carcinoma: predictive value of CT findings [J]. AJR Am J Roentgenol， 1992; 158(6)∶1247.
6.	Nagasue N, Inokuchi K, Kobayashi M, et al. Hepatoportal arteriovenous fistula in primary carcinoma of the liver [J]. Surg Gynecol Obstet， 1977; 145(4)∶504.
7.	Zhu LX, Wang GS, Fan ST. Spontaneous rupture of hepatocellular carcinoma [J]. Br J Surg， 1996; 83(5)∶602.
8.	Zhu LX, Geng XP, Fan ST. Spontaneous rupture of hepatocellular carcinoma and vascular injury [J]. Arch Surg, 2001; 136(6)∶682.
9.	Zhu LX, Liu Y, Fan ST. Ultrastructural study of the vascular endothelium of patients with spontaneous rupture of hepatocellular carcinoma [J]. Asian J Surg, 2002; 25(2)∶157.
10.	Zhu LX, Meng XL, Fan ST. Elasticity of small artery in patient with spontaneous rupture of hepatocellular carcinoma [J]. Hepatol Res, 2004; 29(1)∶13.
11.	朱立新，耿小平，范上达. 肝癌自发性破裂与抗原抗体复合物的库管沉积 [J]. 中华肝胆外科杂志， 2001； 7（11）∶674.
12.	Cooper NR Eds. Adv immunol [M]. New York： Hirsch, 1985∶151-216.
13.	Fan PT, Davis JA, Somer T, et al. A clinical approach to systemic vasculitis [J]. Semin Arthritis Rheum, 1980; 9(4)∶248.
14.	Leib ES, Hibrawi H, Chia D, et al. Correlation of disease activity in systemic necrotizing vasculitis with immune complexes [J]. J Rheumatol, 1981; 8(2)∶258.
15.	Assoian RK, Sporn MB. Type beta transforming growth factor in human platelets: release during platelet degranulation and action on vascular smooth muscle cells [J]. J Cell Biol, 1986; 102(4)∶1217.
16.	Ross R. Plateletdrived growth factor [J]. Lancet, 1989; 1(8648)∶179.
17.	Cozzolino F, Torcia M, Lucibello M, et al. Interferonalpha and interleukin 2 synergistically enhance basic fibroblast growth factor synthesis and induce release, promoting endothelial cell growth [J]. J Clin Invest, 1993; 91(6)∶2504.
18.	Ghadially FN Eds. Ultrastructure pathology of the cell and matrix [M]. London: Butterworths, 1988∶1099-1129.
19.	Johannessen JV Eds. Electron microscopy in human medicine [M]. New York: McGAWHALL, 1980∶94-154.
20.	Tsuboi R, Sato Y, Rifkin DB. Correlation of cell migration, cell invasion, receptor number, proteinase production, and basic fibroblast growth factor levels in endothelial cells [J]. J Cell Biol, 1990; 110(2)∶511.
21.	James TW, Wagner R, White LA, et al. Induction of collagenase and stromelysin gene expression by mechanical injury in a vascular smooth musclederived cell line [J]. J Cell Physiol, 1993; 157(2)∶426.
22.	Dobrin PB, Mrkvicka R. Failure of elastin or collagen as possible critical connective tissue alterations underlying aneurysmal dilatation [J]. Cardiovasc Surg， 1994; 2(4)∶484.
23.	Liu CL, Fan ST, Lo CM, et al. Management of spontaneous rupture of hepatocellular carcinoma: singlecenter experience [J]. J Clin Oncol， 2001; 19(17)∶3725.

1. Miyamoto M, Sudo T, Kuyama T. Spontaneous rupture of hepatocellular carcinoma: a review of 172 Japanese cases [J]. Am J Gastroenterol， 1991; 86(1)∶67.
2. Chearanai O, Plengvanit U, Asavanich C, et al. Spontaneous rupture of primary hepatoma: report of 63 cases with particular reference to the pathogenesis and rationale treatment by hepatic artery ligation [J]. Cancer， 1983; 51(8)∶1532.
3. Kew MC, Hodkinson J. Rupture of hepatocellular carcinoma as a result of blunt abdominal trauma [J]. Am J Gastroenterol， 1991; 86(8)∶1083.
4. Hermann RE, David TE. Spontaneous rupture of the liver caused by hepatomas [J]. Surgery， 1973; 74(5)∶715.
5. Kanematsu M, Imaeda T, Yamawaki Y, et al. Rupture of hepatocellular carcinoma: predictive value of CT findings [J]. AJR Am J Roentgenol， 1992; 158(6)∶1247.
6. Nagasue N, Inokuchi K, Kobayashi M, et al. Hepatoportal arteriovenous fistula in primary carcinoma of the liver [J]. Surg Gynecol Obstet， 1977; 145(4)∶504.
7. Zhu LX, Wang GS, Fan ST. Spontaneous rupture of hepatocellular carcinoma [J]. Br J Surg， 1996; 83(5)∶602.
8. Zhu LX, Geng XP, Fan ST. Spontaneous rupture of hepatocellular carcinoma and vascular injury [J]. Arch Surg, 2001; 136(6)∶682.
9. Zhu LX, Liu Y, Fan ST. Ultrastructural study of the vascular endothelium of patients with spontaneous rupture of hepatocellular carcinoma [J]. Asian J Surg, 2002; 25(2)∶157.
10. Zhu LX, Meng XL, Fan ST. Elasticity of small artery in patient with spontaneous rupture of hepatocellular carcinoma [J]. Hepatol Res, 2004; 29(1)∶13.
11. 朱立新，耿小平，范上达. 肝癌自发性破裂与抗原抗体复合物的库管沉积 [J]. 中华肝胆外科杂志， 2001； 7（11）∶674.
12. Cooper NR Eds. Adv immunol [M]. New York： Hirsch, 1985∶151-216.
13. Fan PT, Davis JA, Somer T, et al. A clinical approach to systemic vasculitis [J]. Semin Arthritis Rheum, 1980; 9(4)∶248.
14. Leib ES, Hibrawi H, Chia D, et al. Correlation of disease activity in systemic necrotizing vasculitis with immune complexes [J]. J Rheumatol, 1981; 8(2)∶258.
15. Assoian RK, Sporn MB. Type beta transforming growth factor in human platelets: release during platelet degranulation and action on vascular smooth muscle cells [J]. J Cell Biol, 1986; 102(4)∶1217.
16. Ross R. Plateletdrived growth factor [J]. Lancet, 1989; 1(8648)∶179.
17. Cozzolino F, Torcia M, Lucibello M, et al. Interferonalpha and interleukin 2 synergistically enhance basic fibroblast growth factor synthesis and induce release, promoting endothelial cell growth [J]. J Clin Invest, 1993; 91(6)∶2504.
18. Ghadially FN Eds. Ultrastructure pathology of the cell and matrix [M]. London: Butterworths, 1988∶1099-1129.
19. Johannessen JV Eds. Electron microscopy in human medicine [M]. New York: McGAWHALL, 1980∶94-154.
20. Tsuboi R, Sato Y, Rifkin DB. Correlation of cell migration, cell invasion, receptor number, proteinase production, and basic fibroblast growth factor levels in endothelial cells [J]. J Cell Biol, 1990; 110(2)∶511.
21. James TW, Wagner R, White LA, et al. Induction of collagenase and stromelysin gene expression by mechanical injury in a vascular smooth musclederived cell line [J]. J Cell Physiol, 1993; 157(2)∶426.
22. Dobrin PB, Mrkvicka R. Failure of elastin or collagen as possible critical connective tissue alterations underlying aneurysmal dilatation [J]. Cardiovasc Surg， 1994; 2(4)∶484.
23. Liu CL, Fan ST, Lo CM, et al. Management of spontaneous rupture of hepatocellular carcinoma: singlecenter experience [J]. J Clin Oncol， 2001; 19(17)∶3725.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Mechanism of Spontaneous Rupture of Hepatocellular Carcinoma

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