fig5

Figure 5. Tumor blood flows and multistep hepatocarcinogenesis. The development of hepatocellular carcinoma (HCC) occurs through a multistep process in the following sequence: large regenerative nodule (RN), low- or high-grade dysplastic nodule (DN), DN with a focus of HCC, well differentiated HCC, and moderately to poorly differentiated HCC. During the dedifferentiation, the intratumoral areas supplied portal blood flow are gradually reduced, whereas the intratumoral areas supplied arterial blood flow are synchronously changed. Normal arterial blood supply is reduced at an early stage, and then abnormal arterial blood supply is finally replaced