case_images: PMC6465753_01
case_images: Hepatocellular carcinoma (HCC) before operation. a Contrast-enhanced computed tomography of the HCC. A huge HCC occupied most of the right lobe of the liver (dashed white lines circle the HCC). Small metastatic lesions (white and black arrows) were suspected at the surface of the left lobe of the liver. b Histochemical analysis of EpCAM and NCAM expression in the primary and metastatic tumor lesions and in the blood vessels. The tissues were counterstained with hematoxylin. In the primary lesions, 5-10% of cancer cells were EpCAM positive and 10-20% of cancer cells were NCAM positive (uppermost panels). In the blood vessels, cancer cells that were heterogeneously stained for EpCAM and NCAM were frequently detected (panels second from the top). In the metastatic lesions (bottom four panels), heterogeneously stained HPC marker-positive tumors were also detected; however, the frequency of HPC-positive cancer cells differed according to the tumor. Scale bar = 50 mum.
case_images: crg-0013-0118-g01.jpg
case_images: PMC6465753_01_crg-0013-0118-g01.jpg
case_images: F1
case_images: Contrast-enhanced computed tomography was performed, revealing a huge HCC that occupied most of the right lobe of the liver, as well as some very small metastatic nodules that were suspected in the left lobe of the liver (Fig. 1a). By using this scale, the tumor in the primary lesion was characterized as NCAM2+ and EpCAM1+ (Fig. 1b). Regarding 2: the number of specific HPC marker-positive cancer cells in the vessels/the number of total cancer cells in the vessels was 34/134 (24.3%) for NCAM- and 42/140 (30.0%) for EpCAM-positive cells (Fig. 1b and 2).
case_images: Quantification of HPC marker-positive cancer cells in the primary tumor, tumor-invaded vessels, and metastatic nodules. In the primary lesion, the percentage of cancer cells that were EpCAM- or NCAM-positive was 5-10% and 10-20%, respectively. In the cancer-invaded blood vessels, both the ratio of the number of vessels invaded by specific HPC marker-positive cancer cells/the total number of vessels invaded by cancer cells and the ratio of the number of specific HPC marker-positive cancer cells in the vessel/the total number of cancer cells in the vessel were much higher than the corresponding ratios in the primary lesion. In the metastatic lesions, the frequency of EpCAM- or NCAM-positive cancer cells differed according to the tumor, and the bigger tumors tended to include HPC marker-positive cancer cells.
case_images: crg-0013-0118-g02.jpg
case_images: PMC6465753_01_crg-0013-0118-g02.jpg
case_images: F2
case_images: Regarding 2: the number of specific HPC marker-positive cancer cells in the vessels/the number of total cancer cells in the vessels was 34/134 (24.3%) for NCAM- and 42/140 (30.0%) for EpCAM-positive cells (Fig. 1b and 2). The other four smaller tumors, which were of the following size: (5) 2 x 2 mm, (6) 2 x 2 mm, (7) 2 x 2 mm, and (8) 2 x 1 mm, did not express any markers (Fig. 2).