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Jai Young Cho 3 Articles
The Clinicopathological and Prognostic Significance of the Gross Classification of Hepatocellular Carcinoma
Yangkyu Lee, Hyunjin Park, Hyejung Lee, Jai Young Cho, Yoo-Seok Yoon, Young-Rok Choi, Ho-Seong Han, Eun Sun Jang, Jin-Wook Kim, Sook-Hyang Jeong, Soomin Ahn, Haeryoung Kim
J Pathol Transl Med. 2018;52(2):85-92.   Published online November 24, 2017
  • 8,919 View
  • 307 Download
  • 15 Citations
AbstractAbstract PDF
We aimed to determine the clinicopathological significance of the gross classification of hepatocellular carcinoma (HCC) according to the Korean Liver Cancer Association (KLCA) guidelines.
A retrospective analysis was performed on 242 cases of consecutively resected solitary primary HCC between 2003 and 2012 at Seoul National University Bundang Hospital. The gross classification (vaguely nodular [VN], expanding nodular [EN], multinodular confluent [MC], nodular with perinodular extension [NP], and infiltrative [INF]) was reviewed for all cases, and were correlated with various clinicopathological features and the expression status of “stemness”-related (cytokeratin 19 [CK19], epithelial cell adhesion molecule [EpCAM]), and epithelial-mesenchymal transition (EMT)–related (urokinase plasminogen activator receptor [uPAR] and Ezrin) markers.
Significant differences were seen in overall survival (p=.015) and disease-free survival (p = .034) according to the gross classification; INF type showed the worst prognosis while VN and EN types were more favorable. When the gross types were simplified into two groups, type 2 HCCs (MC/NP/INF) were more frequently larger and poorly differentiated, and showed more frequent microvascular and portal venous invasion, intratumoral fibrous stroma and higher pT stages compared to type 1 HCCs (EN/VN) (p<.05, all). CK19, EpCAM, uPAR, and ezrin expression was more frequently seen in type 2 HCCs (p<.05, all). Gross classification was an independent predictor of both overall and disease-free survival by multivariate analysis (overall survival: p=.030; hazard ratio, 4.118; 95% confidence interval, 1.142 to 14.844; disease-free survival: p=.016; hazard ratio, 1.617; 95% confidence interval, 1.092 to 2.394).
The gross classification of HCC had significant prognostic value and type 2 HCCs were associated with clinicopathological features of aggressive behavior, increased expression of “stemness”- and EMT-related markers, and decreased survival.


Citations to this article as recorded by  
  • Recurrence of hepatocellular carcinoma in noncirrhotic patients with nonalcoholic fatty liver disease versus hepatitis B infection
    Jungnam Lee, Jong-In Chang, Young-Joo Jin, Jeong-Hoon Lee, Ju Yeon Kim, Dong Hyun Sinn, Soon Sun Kim, Hyun Woong Lee, Sun Hong Yoo, Jung Hwan Yu, Jin-Woo Lee
    European Journal of Gastroenterology & Hepatology.2023; 35(4): 431.     CrossRef
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    Salvatore Lorenzo Renne, Luca Di Tommaso
    Journal of Liver Cancer.2022; 22(1): 14.     CrossRef
  • An approach to grossing of hepatectomy specimens
    Archana Rastogi
    Indian Journal of Pathology and Microbiology.2021; 64(5): 121.     CrossRef
  • Hepatocellular carcinoma: a clinical and pathological overview
    Salvatore Lorenzo Renne, Samantha Sarcognato, Diana Sacchi, Maria Guido, Massimo Roncalli, Luigi Terracciano, Luca Di Tommaso
    Pathologica.2021; 113(3): 203.     CrossRef
  • The Clinicopathological Significance of YAP/TAZ Expression in Hepatocellular Carcinoma with Relation to Hypoxia and Stemness
    Hyunjin Park, Yangkyu Lee, Kiryang Lee, Hyejung Lee, Jeong Eun Yoo, Soomin Ahn, Young Nyun Park, Haeryoung Kim
    Pathology and Oncology Research.2021;[Epub]     CrossRef
  • Adjuvant versus Neoadjuvant Immunotherapy for Hepatocellular Carcinoma: Clinical and Immunologic Perspectives
    Yung-Yeh Su, Chia-Chen Li, Yih-Jyh Lin, Chiun Hsu
    Seminars in Liver Disease.2021; 41(03): 263.     CrossRef
  • Prognostic significance of viable tumor size measurement in hepatocellular carcinomas after preoperative locoregional treatment
    Yoon Jung Hwang, Youngeun Lee, Hyunjin Park, Yangkyu Lee, Kyoungbun Lee, Haeryoung Kim
    Journal of Pathology and Translational Medicine.2021; 55(5): 338.     CrossRef
  • Survival according to recurrence patterns after resection for transplantable hepatocellular carcinoma in HBV endemic area: Appraisal of liver transplantation strategy
    Chung Gyo Seo, Sun Young Yim, Soon Ho Um, Yoo Ra Lee, Yoo Jin Lee, Tae Hyung Kim, Hyun Gil Goh, Young Sun Lee, Sang Jun Suh, Na Yeon Han, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yeon Seok Seo, Hyung Joon Yim, Ji Hoon Kim, Dong Sik Kim, Yoon Tae Jeen, Hoon
    Clinics and Research in Hepatology and Gastroenterology.2020; 44(4): 532.     CrossRef
  • A radiomics-based biomarker for cytokeratin 19 status of hepatocellular carcinoma with gadoxetic acid–enhanced MRI
    Wentao Wang, Dongsheng Gu, Jingwei Wei, Ying Ding, Li Yang, Kai Zhu, Rongkui Luo, Sheng-Xiang Rao, Jie Tian, Mengsu Zeng
    European Radiology.2020; 30(5): 3004.     CrossRef
  • Paeonol Inhibits Cell Proliferation, Migration and Invasion and Induces Apoptosis in Hepatocellular Carcinoma by Regulating miR-21-5p/KLF6 Axis

    Miaoguo Cai, Wei Shao, Huijun Yu, Ye Hong, Lili Shi
    Cancer Management and Research.2020; Volume 12: 5931.     CrossRef
  • Update on Hepatocellular Carcinoma: a Brief Review from Pathologist Standpoint
    Nese Karadag Soylu
    Journal of Gastrointestinal Cancer.2020; 51(4): 1176.     CrossRef
  • Clinico-Radio-Pathological and Molecular Features of Hepatocellular Carcinomas with Keratin 19 Expression
    Hyungjin Rhee, Haeryoung Kim, Young Nyun Park
    Liver Cancer.2020; 9(6): 663.     CrossRef
  • Histopathological characteristics of needle core biopsy and surgical specimens from patients with solitary hepatocellular carcinoma or intrahepatic cholangiocarcinoma
    Ju-Shan Wu, Ji-Liang Feng, Rui-Dong Zhu, San-Guang Liu, Da-Wei Zhao, Ning Li
    World Journal of Gastrointestinal Oncology.2019; 11(5): 404.     CrossRef
  • The strengths and weaknesses of gross and histopathological evaluation in hepatocellular carcinoma: a brief review
    Sebastião N. Martins-Filho, Venâncio Avancini Ferreira Alves
    Surgical and Experimental Pathology.2019;[Epub]     CrossRef
  • Changing role of histopathology in the diagnosis and management of hepatocellular carcinoma
    Archana Rastogi
    World Journal of Gastroenterology.2018; 24(35): 4000.     CrossRef
SALL4 Expression in Hepatocellular Carcinomas Is Associated with EpCAM-Positivity and a Poor Prognosis
Hyunjin Park, Hyejung Lee, An Na Seo, Jai Young Cho, Young Rok Choi, Yoo-Seok Yoon, Ho-Seong Han, Young Nyun Park, Haeryoung Kim
J Pathol Transl Med. 2015;49(5):373-381.   Published online August 10, 2015
  • 9,055 View
  • 71 Download
  • 19 Citations
AbstractAbstract PDF
There is increasing interest in hepatocellular carcinomas (HCC) expressing “stemness”-related markers, as they have been associated with aggressive behavior and poor prognosis. In this study, we investigated the usefulness of Sal-like protein 4 (SALL4), a recently proposed candidate marker of “stemness.” Methods: Immunohistochemical stains were performed for SALL4, K19, and epithelial cellular adhesion molecule (EpCAM) on tissue microarrays constructed from 190 surgically resected HCCs, and the results were correlated with the clinicopathological features and patient survival data. Results: Nuclear SALL4 expression was observed in 39/190 HCCs (20.5%), while K19 and EpCAM were expressed in 30 (15.9%) and 92 (48.7%) HCCs, respectively. The nuclear expression was generally weak, punctate or clumped. SALL4 expression was significantly associated with a poor overall survival compared to SALL4-negative HCCs (p = .014) compared to SALL4-negative HCCs. On multivariate analysis adjusted for tumor size, multiplicity, vascular invasion, and pathological tumor stage, SALL4 remained as a significant independent predictor of decreased overall survival (p= .004). SALL4 expression was positively correlated with EpCAM expression (p = .013) but not with K19 expression. HCCs that expressed both SALL4 and EpCAM were associated with significantly decreased overall survival, compared to those cases which were negative for both of these markers (p = .031). Conclusions: Although SALL4 expression was not significantly correlated with other clinicopathological parameters suggestive of tumor aggressiveness, SALL4 expression was an independent predictor of poor overall survival in human HCCs, and was also positively correlated with EpCAM expression.


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  • Hepatoid Teratoma, Hepatoid Yolk Sac Tumor, and Hepatocellular Carcinoma
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    American Journal of Surgical Pathology.2021; 45(1): 127.     CrossRef
  • Targeting an Inducible SALL4-Mediated Cancer Vulnerability with Sequential Therapy
    Junyu Yang, Chong Gao, Miao Liu, Yao-Chung Liu, Junsu Kwon, Jun Qi, Xi Tian, Alicia Stein, Yanjing V. Liu, Nikki R. Kong, Yue Wu, Shenyi Yin, Jianzhong Xi, Zhiyuan Chen, Kalpana Kumari, Hannan Wong, Hongbo Luo, Leslie E. Silberstein, Julie A.I. Thoms, Ash
    Cancer Research.2021; 81(23): 6018.     CrossRef
  • Lipoprotein‐Like Nanoparticle Carrying Small Interfering RNA Against Spalt‐Like Transcription Factor 4 Effectively Targets Hepatocellular Carcinoma Cells and Decreases Tumor Burden
    William Cruz, Huang Huang, Brian Barber, Elisa Pasini, Lili Ding, Gang Zheng, Juan Chen, Mamatha Bhat
    Hepatology Communications.2020; 4(5): 769.     CrossRef
  • Hepatoid adenocarcinoma of the stomach: a unique subgroup with distinct clinicopathological and molecular features
    Yakun Wang, Li Sun, Zhongwu Li, Jing Gao, Sai Ge, Cheng Zhang, Jiajia Yuan, Xicheng Wang, Jian Li, Zhihao Lu, Jifang Gong, Ming Lu, Jun Zhou, Zhi Peng, Lin Shen, Xiaotian Zhang
    Gastric Cancer.2019; 22(6): 1183.     CrossRef
  • Gynecologic Serous Carcinoma: An Immunohistochemical Analysis of Malignant Body Fluid Specimens
    Shuyue Ren, William Klump
    Archives of Pathology & Laboratory Medicine.2019; 143(6): 677.     CrossRef
  • The pluripotency network in colorectal cancer pathogenesis and prognosis: an update
    Ioannis A Voutsadakis
    Biomarkers in Medicine.2018; 12(6): 653.     CrossRef
  • Cancer stem cells in hepatocellular carcinoma: an overview and promising therapeutic strategies
    Nuozhou Wang, Shanshan Wang, Ming-Yue Li, Bao-guang Hu, Li-ping Liu, Sheng-li Yang, Shucai Yang, Zhongqin Gong, Paul B. S. Lai, George G. Chen
    Therapeutic Advances in Medical Oncology.2018; 10: 175883591881628.     CrossRef
  • DNA demethylation induces SALL4 gene re-expression in subgroups of hepatocellular carcinoma associated with Hepatitis B or C virus infection
    H Fan, Z Cui, H Zhang, S K Mani, A Diab, L Lefrancois, N Fares, P Merle, O Andrisani
    Oncogene.2017; 36(17): 2435.     CrossRef
  • Higher expression of SALL4 predicts poor cancer prognosis: A meta-analysis
    Hongyu Shen, Liangpeng Li, Dandan Wang, Sujin Yang, Xiu Chen, Siying Zhou, Shanliang Zhong, Jianhua Zhao, Jinhai Tang
    Cancer Biomarkers.2017; 19(4): 365.     CrossRef
  • SALL4 suppresses PTEN expression to promote glioma cell proliferation via PI3K/AKT signaling pathway
    Chuanjin Liu, Haibin Wu, Yanyan Li, Liang Shen, Renchun Yu, Hongwei Yin, Ting Sun, Chunming Sun, Youxin Zhou, Ziwei Du
    Journal of Neuro-Oncology.2017; 135(2): 263.     CrossRef
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    Germana Castelli, Elvira Pelosi, Ugo Testa
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    Lorenzo Nicolè, Tiziana Sanavia, Nicola Veronese, Rocco Cappellesso, Claudio Luchini, Paolo Dabrilli, Ambrogio Fassina
    Oncotarget.2017; 8(14): 22968.     CrossRef
  • SALL4, the missing link between stem cells, development and cancer
    Hiro Tatetsu, Nikki R. Kong, Gao Chong, Giovanni Amabile, Daniel G. Tenen, Li Chai
    Gene.2016; 584(2): 111.     CrossRef
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    Soo Jeong Nam, Hyun Yang Yeo, Hee Jin Chang, Bo Hyun Kim, Eun Kyung Hong, Joong-Won Park
    Cancer Research and Treatment.2016; 48(4): 1229.     CrossRef
  • Functional and clinical significance of SALL4 in breast cancer
    Ebubekir Dirican, Mustafa Akkiprik
    Tumor Biology.2016; 37(9): 11701.     CrossRef
  • MicroRNA-33b suppresses the proliferation and metastasis of hepatocellular carcinoma cells through the inhibition of Sal-like protein 4 expression
    Qinggang Tian, Yao Xiao, Yanting Wu, Yun Liu, Zhiqing Song, Wenfeng Gao, Jing Zhang, Jingling Yang, Yuguo Zhang, Tuankui Guo, Furong Dai, Zhigang Sun
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    Oncotarget.2016; 7(17): 24314.     CrossRef
Chemotherapy-Associated Hepatopathy in Korean Colorectal Cancer Liver Metastasis Patients: Oxaliplatin-Based Chemotherapy and Sinusoidal Injury
Soo Jeong Nam, Jai Young Cho, Hye Seung Lee, Gheeyoung Choe, Ja June Jang, Yoo-Seok Yoon, Ho-Seong Han, Haeryoung Kim
Korean J Pathol. 2012;46(1):22-29.   Published online February 23, 2012
  • 6,692 View
  • 60 Download
  • 12 Citations
AbstractAbstract PDF

Although chemotherapy-related hepatic injury has been reported in colorectal cancer liver metastasis (CRLM) patients, the morphologic changes caused by chemotherapeutic agents and the effect of chemotherapy on postoperative outcome remain ill-defined. A comprehensive review of the morphologic changes in the post-chemotherapy non-neoplastic liver was performed and the clinical effect of preoperative chemotherapy in CRLM patients was analyzed.


Hematoxylin-eosin, Masson's trichrome and reticulin-stained slides from non-neoplastic livers obtained from 89 CRLM patients were analyzed, and the clinicopathologic features were correlated with the status of chemotherapy exposure.


Histopathologic features of sinusoidal injury (sinusoidal dilatation, centrilobular perivenular fibrosis, parenchymal extinction lesions, small vessel obliteration, and hepatocyte plate disruption) were significantly more frequent in oxaliplatin-exposed livers (p<0.05). The extent of sinusoidal dilatation was positively correlated with increasing numbers of chemotherapy cycles (p=0.022). Abnormal preoperative liver function tests were more frequently seen (p<0.05) and postoperative total bilirubin was higher in the chemotherapy group (p=0.008). Postoperative morbidity was more common in the chemotherapy group (p=0.044).


Sinusoidal injury is frequently seen in oxaliplatin-treated livers, and its presence, especially when extensive, should be documented in surgical pathology practice. The recognition of sinusoidal injury may provide helpful guidelines for surgeons in deciding the extent of hepatic resection.


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    An Na Seo, Haeryoung Kim
    Clinical and Molecular Hepatology.2014; 20(1): 81.     CrossRef
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JPTM : Journal of Pathology and Translational Medicine