Clinicopathological and prognostic features of primary clear cell carcinoma of the liver

Aim: Primary clear cell carcinoma of the liver (PCCCL) is a subgroup of primary hepatocellular carcinoma (HCC), pathologically characterized by diffuse clear cells of the tumor, showing a clear cytoplasm that does not stain with hematoxylin–eosin. At present, its clinicopathological and prognostic features are not fully clarified. This study aims to clarify the clinicopathological and prognostic features of PCCCL. Methods: The clinicopathological data of 43 patients with PCCCL treated with hepatectomy in our hospital from January 1999 to December 2003 were retrospectively analyzed. Results: The χ2-test showed a positive rate of hepatitis C virus (HCV) infection and capsule formation in the PCCCL group, which was markedly higher than in the common type HCC (CHCC) group (P = 0.000 and P = 0.005). Meanwhile, the vascular invasion rate was notably lower in the PCCCL group, but there were no significant differences between the twogroups (P = 0.129). The Kaplan–Meier method showed that the 1-, 3-, and 5-year survival rates were significantly higher in the PCCCL group than in the CHCC group (P = 0.021). The prognosis of patients in the PCCCL group was related to capsule formation, vascular invasion, liver cirrhosis, and clear cell ratio. The 1-, 3-, and 5-year survival rates were markedly higher in the group with a higher clear cell ratio than in the group with a lower clear cell ratio (P = 0.011). Conclusion: The notable clinicopathological features of the patients in the PCCCL group included a higher rate of HCV infection, capsule formation, and a lower rate of vascular invasion. The prognosis was better than that of the patients in the CHCC group and related to the ratio of clear cells.