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Wang et al. Hepatoma Res 2018;4:14 Hepatoma Research
DOI: 10.20517/2394-5079.2018.16

Review Open Access

New strategy to distinguish clonal origin of RHCC/
MHCC between intrahepatic metastasis and

multicentric occurrence

Han Wang, Wen-Ming Cong

Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
Correspondence to: Dr. Wen-Ming Cong, Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military
Medical University, Changhai Road 225, Shanghai 200438, China. E-mail: wmcong@smmu.edu.cn
How to cite this article: Wang H, Cong WM. New strategy to distinguish clonal origin of RHCC/MHCC between intrahepatic
metastasis and multicentric occurrence. Hepatoma Res 2018;4:14. http://dx.doi.org/10.20517/2394-5079.2018.16
Received: 5 Mar 2018 First Decision: 13 Apr 2018 Revised: 19 Apr 2018 Accepted: 20 Apr 2018 Published: 28 May 2018

Science Editor: Guang-Wen Cao Copy Editor: Guang-Zhe Zhu Production Editor: Cai-Hong Wang

Abstract
Hepatocellular carcinoma (HCC) is a kind of malignancy with high potential of metastasis and multicentric occurrence.
The treatment of recurrent hepatocellular carcinoma (RHCC) and multinodular hepatocellular carcinoma (MHCC) is
always a nodus because of the diverse clonal origin of RHCC/MHCC. Theoretically, the RHCC/MHCC can originate
from intrahepatic metastasis (IM type) or multicentric occurrence (MO type). Our previous study proposed that there
are at least 6 subtypes of clonal origin patterns in RHCC. RHCC and MHCC with different clonal origins have variant
biological behaviors, clinical prognosis as well as treatment strategy. Generally speaking, patients with IM type HCC
have a poorer prognosis compared with those with MO type HCC. Therefore, it is essential to emphasize the distribution
of the clonal origin in HCC in order to determine the choice of clinical treatment. Undoubtedly, the detection of clonal
origin pattern will become a promising breakthrough in the molecular pathological diagnosis of HCC. We should attach
more attention to the establishment of a standardized molecular pathological clonal origin detection method and a new
stratification of clinical treatment choice for RHCC/MHCC in future.

Keywords: Hepatocellular carcinoma, clonal origin, molecular pathology, recurrent hepatocellular carcinoma, multinodular
hepatocellular carcinoma, intrahepatic metastasis, multicentric occurrence

INTRODUCTION
Hepatocellular carcinoma (HCC) is one of the most common cancer related fatal diseases in the world,
especially in China. The resent cancer statistics of China showed that its incidence was in the fourth place,

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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