目的：探讨出血坏死表型肝细胞癌（HN-HCC）瘤内微血管（MV）特征。方法：收集104例HCC样本，其中HN-HCC 72例，非HN-HCC（NHN-HCC）32例。将每例HCC样本均划分为癌组织中央区、肿瘤中心到肿瘤边缘中间区、肿瘤边缘区3个区域，分别比较两种类型HCC样本对应区域间MV形态特征以及血管生成相关基因BTB/POZ结构域蛋白7（BTBD7）、缺氧诱生因子1α（HIF-1α）、促血管生成素2（Ang-2）的mRNA表达的差异。结果：HCC瘤内MV形态分为肿瘤细胞簇包绕型血管（VETC）、毛细管状血管（CV）和两者混合型（VETC+CV）。两者相应区域间比较，HN-HCC各区域VETC阳性率均高于NHN-HCC（65% vs. 29%、76% vs. 9%、70% vs. 16%），CV阳性率均低于NHN-HCC组（23% vs. 55%、3% vs. 72%、11% vs. 59%），差异均有统计学意义（均P<0.05），但VETC+CV阳性率均无差异（均P>0.05）；HN-HCC各区域BTBD7，HIF-1α，Ang-2 mRNA的表达水平均高于NHN-HCC（均P<0.05）。结论：HN-HCC瘤内MV形态构筑紊乱且血管生成相关基因异常表达，可能是导致肿瘤局部缺血缺氧及侵袭转移重要原因。
Features of intratumoral microvessels in hepatocellular carcinoma with hemorrhagic/necrotic phenotype
Objective: To analyze the features of intratumoral microvessels (MV) in hepatocellular carcinoma with hemorrhagic/necrotic phenotype (HN-HCC). Methods: A total of 104 specimens of HCC were collected, which included 72 cases of HN-HCC and 32 cases of non-HN-HCC (NHN-HCC). Each HCC specimen was divided into 3 regions designated as the central region of the tumor, intermediate region between the core and margin of the tumor and marginal region of the tumor. The differences in morphological profiles of the intratumoral MV and mRNA expressions of angiogenesis-associated genes that included the BTB/POZ domain-containing protein 7 (BTBD7), hypoxia-inducible factor 1α (HIF-1α) and angiopoietin 2 (Ang-2) between the parallel regions of the two types of HCC were compared. Results: The patterns of the intratumoral MV were classified as vessels that encapsulated tumor clusters (VETC), capillary vessels (CV) and combined VETC and CV (VETC+CV). Comparison between the parallel regions of the two types of HCC showed that in each parallel region of HN-HCC compared with NHN-HCC, the VETC positive rate was increased (65% vs. 29%, 76% vs. 9%, 70% vs.16%), while the CV positive rate was decreased (23% vs. 55%, 3% vs. 72%, 11% vs. 59%) and all differences had statistical significance (all P<0.05), but the VETC+CV positive rate had no difference (all P>0.05); the mRNA expressions of BTBD7, HIF-1α, and Ang-2 were all significantly up-regulated (all P<0.05). Conclusion: There is disorder of intratumoral MV architecture with aberrant expressions of angiogenesis-associated genes in HN-HCC, which may induce local hypoxia and ischemia as well as tumor invasion and metastasis.