Reginelli Alfonso, Vanzulli Angelo, Sgrazzutti Cristiano, Caschera Luca, Serra Nicola, Raucci Antonio, Urraro Fabrizio, Cappabianca Salvatore
Department of Internal and Experimental Medicine, Second University of Naples, Naples, Italy.
Niguarda Cancer Center - ASST Grande Ospedale Metropolitano, University of Milano, Niguarda, Milan, Italy.
Med Oncol. 2017 May;34(5):93. doi: 10.1007/s12032-017-0949-7. Epub 2017 Apr 12.
Recurrence of HCC reduces survival rates in patients treated with surgery, and one of the most relevant risk factors for tumour recurrence is microvascular invasion (mVI). The identification of mVI on preoperative examinations could improve surgical planning's and techniques so as to reduce the risk of tumour recurrence. During our study, we have revised 101 CT examinations of the liver performed on patients diagnosed with solitary HCC who had surgical treatment and pathological analysis of the specimens for mVI in order to detect CT signs which could be reliable in mVI prediction. On CT examinations, the tumours were evaluated for margins, capsule, size, contrast enhancement, halo sign and Thad. From our statistical analysis, we found out that irregularity in tumour margins and defects in peritumoural capsule are the most significant characteristics predicting mVI in HCC. Every report on CT examinations performed on surgical candidate patients should include suggestions about mVI probability in order to tailor procedures, reduce tumour recurrence risk and improve survival rates.
肝癌复发会降低接受手术治疗患者的生存率，而微血管侵犯（mVI）是肿瘤复发最相关的危险因素之一。术前检查中识别mVI可改进手术规划和技术，从而降低肿瘤复发风险。在我们的研究中，我们回顾了101例经手术治疗并对标本进行mVI病理分析的孤立性肝癌患者的肝脏CT检查，以检测在mVI预测中可能可靠的CT征象。在CT检查中，对肿瘤的边缘、包膜、大小、对比增强、晕征和Thad进行评估。通过我们的统计分析，我们发现肿瘤边缘不规则和肿瘤周围包膜缺损是预测肝癌mVI的最显著特征。对手术候选患者进行的每一份CT检查报告都应包含关于mVI可能性的建议，以便调整手术方案、降低肿瘤复发风险并提高生存率。
