The collaborative research group of Hidetoshi Nakagawa, Team Leader, Mayuko Furuta, and Professor Hiroki Yamagami of the Second Department of Foreign Science, Wakayama Prefectural Medical University, is recurrent. Alternatively, whole-genome sequence analysis is performed on lesions of multiple liver cancers, and whether the developed liver cancer is a recurrent cancer due to metastasis derived from the same cancer cell or multiple cancer cells derived from different cancer cells. I succeeded in diagnosing it accurately.

 In Japan, about 4 people are diagnosed with liver cancer annually, and more than 3 die. When infected with hepatitis B or C virus, liver cancer develops with high probability from chronic hepatitis to liver cirrhosis.Chronic hepatitis and cirrhosis have a strong risk of carcinogenesis, so cancer may occur independently and frequently in the same liver (multiple carcinogenesis, multicentric carcinogenesis).In addition, it most often recurs in the same liver as metastasis after treatment such as surgery (intrahepatic metastasis).In this way, liver tumors often appear in the liver, but are these liver cancers recurrent liver cancers due to intrahepatic metastasis, or multiple (multicentric) liver cancers? It is still not easy to accurately diagnose this by clinical information, imaging tests, and pathological tests.

 The collaborative research group sequenced the entire genome of 23 recurrent or multiple liver cancer lesions from 49 patients with liver cancer and shared them with liver tumors that occurred in the same patient. The rate of somatic mutations was investigated.As a result, there is a clear division between a group with many common mutations (common to 20-80%) and a group with very few common mutations (common to less than 1%) between two or three tumors derived from the same patient, and a group with many common mutations. Was diagnosed as recurrent liver cancer due to intrahepatic metastasis, and the few groups were diagnosed with multiple (multicentric) liver cancer.The results of this genomic diagnosis and the results of preoperative clinical diagnosis and pathological diagnosis of lesions did not match in a combination of about 1/3.However, because metastatic tumors share genomic abnormalities with the primary lesion, genomic diagnosis may be more accurate.

 With the accurate diagnosis of relapsing / multiple liver cancer, the treatment policy for relapsing / multiple liver cancer may change in the future.

Wakayama Medical University

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