Zhang Tao, Pandey Gaurab, Xu Lin, Chen Wen, Gu Liangrui, Wu Yijun, Chen Xiuwen
Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China.
Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China.
Cancer Manag Res. 2020 Jun 2;12:4097-4105. doi: 10.2147/CMAR.S245475. eCollection 2020.
The objective of our study was to evaluate the value of two-trait predictor of venous invasion (TTPVI) in the prediction of pathological microvascular invasion (pMVI) in patients with hepatocellular carcinoma (HCC) from preoperative computed tomography (CT) and magnetic resonance (MR).
A total of 128 preoperative patients with findings of HCC were enrolled. Tumor size, tumor margins, tumor capsule, peritumoral enhancement, and TTPVI was assessed on preoperative CT and MRI images. Histopathological features were reviewed: pathological tumor size, tumor differentiation, pMVI along with alpha-fetoprotein level (AFP). Significant imaging findings and histopathological features were determined with univariate and multivariate logistic regression analysis.
Univariate analysis revealed that tumor size (<0.01), AFP level (=0.043), tumor differentiation (<0.01), peritumoral enhancement (=0.003), pathological tumor size (<0.01), tumor margins (<0.01) on CT and MRI, and TTPVI (<0.01) showed statistically significant associations with pMVI. In multivariate logistic regression analysis, tumor size (odds ratio [OR] = 1.294; 95% confidence interval [CI]: 1.155, 1.451; < 0.001), tumor differentiation (odds ratio [OR] =1.384; 95% confidence interval [CI]: 1.224, 1.564; < 0.001), and TTPVI (odds ratio [OR] = 4.802; 95% confidence interval [CI]: 1.037, 22.233; =0.045) were significant independent predictors of pMVI. Using 5.8 as the threshold for size, one could obtain an area-under-curve (AUC) of 0.793, 95% confidence interval [CI]: 0.715 to 0.857.
Tumor size, tumor differentiation, and TTPVI depicted in preoperative CT and MRI had a statistically significant correlation with pMVI. Hence, TTPVI detected on CT and MRI may be predictive of pMVI in HCC cases.
本研究的目的是评估术前计算机断层扫描（CT）和磁共振成像（MR）中静脉侵犯双特征预测指标（TTPVI）在预测肝细胞癌（HCC）患者病理微血管侵犯（pMVI）方面的价值。
共纳入128例术前诊断为HCC的患者。在术前CT和MRI图像上评估肿瘤大小、肿瘤边缘、肿瘤包膜、瘤周强化以及TTPVI。回顾组织病理学特征：病理肿瘤大小、肿瘤分化程度、pMVI以及甲胎蛋白水平（AFP）。通过单因素和多因素逻辑回归分析确定显著的影像学表现和组织病理学特征。
单因素分析显示，肿瘤大小（<0.01）、AFP水平（=0.043）、肿瘤分化程度（<0.01）、瘤周强化（=0.003）、CT和MRI上的病理肿瘤大小（<0.01）、肿瘤边缘（<0.01）以及TTPVI（<0.01）与pMVI存在统计学显著关联。在多因素逻辑回归分析中，肿瘤大小（比值比[OR]=1.294；95%置信区间[CI]：1.155，1.451；<0.001）、肿瘤分化程度（比值比[OR]=1.384；95%置信区间[CI]：1.224，1.564；<0.001）以及TTPVI（比值比[OR]=4.802；95%置信区间[CI]：1.037，22.233；=0.045）是pMVI的显著独立预测指标。以5.8作为大小阈值，可获得曲线下面积（AUC）为0.793，95%置信区间[CI]：0.715至0.857。
术前CT和MRI显示的肿瘤大小、肿瘤分化程度以及TTPVI与pMVI存在统计学显著相关性。因此，CT和MRI检测到的TTPVI可能对HCC病例中的pMVI具有预测作用。
