Department of Surgery, Tokushima University, Tokushima City, Japan.
J Hepatobiliary Pancreat Sci. 2020 Jul;27(7):388-395. doi: 10.1002/jhbp.732. Epub 2020 Apr 6.
We evaluated apparent diffusion coefficient (ADC) of diffusion-weighted image MRI as a prognostic factor for mass-forming intrahepatic cholangiocarcinoma (IHCC).
We enrolled 26 patients who had undergone hepatic resections for mass-forming-type IHCC in this study, and calculated their mean ADC, using diffusion-weighted image MRI (b: 0, 20, 800 seconds/mm ; 1.5 T MRI). Patients were divided into the ADC and the ADC groups at the median ADC value (n = 13 for both). We also immunohistochemically evaluated hypoxia-inducible factor (HIF)-1α in tumor tissue.
Median age in the ADC was older (P = .03), and showed significant higher rate of scirrhous tumor (P = .02). The 5-year overall survival rate in the ADC group was significantly worse than in the ADC group (P = .04). In multivariate analysis, hilar tumor, portal vein invasion and low ADC were independent prognostic factors (P < .05). The ADC group also had a higher rate of high HIF-1α expression than the ADC group (P < .05). Representative case of ADC group showed rich stroma and high HIF-1α expression.
The ADC values in MRIs can predict IHCC prognosis, and correlated with stromal density and HIF-1α expression.
我们评估了弥散加权图像 MRI 的表观弥散系数（ADC）作为肿块型肝内胆管细胞癌（IHCC）的预后因素。
本研究纳入了 26 名接受肝切除术治疗肿块型 IHCC 的患者，并使用弥散加权图像 MRI（b 值：0、20、800 秒/mm²；1.5 T MRI）计算了他们的平均 ADC。根据中位 ADC 值将患者分为 ADC 组和 ADC 组（n 均为 13）。我们还对肿瘤组织中的缺氧诱导因子（HIF）-1α进行了免疫组织化学评估。
ADC 组的中位年龄较大（P =.03），且表现出显著更高的硬化型肿瘤发生率（P =.02）。ADC 组的 5 年总生存率明显低于 ADC 组（P =.04）。多因素分析显示，肝门部肿瘤、门静脉侵犯和低 ADC 是独立的预后因素（P <.05）。ADC 组的 HIF-1α高表达率也高于 ADC 组（P <.05）。ADC 组的代表性病例显示丰富的基质和高 HIF-1α表达。
MRI 的 ADC 值可以预测 IHCC 的预后，并与基质密度和 HIF-1α表达相关。
