Department of Oncology, Anhui No. 2 Provincial People's Hospital, Hefei 230041, China.
Department of Radiotherapy, Anhui No. 2 Provincial People's Hospital, Hefei 230041, China.
J Healthc Eng. 2022 Mar 24;2022:2608633. doi: 10.1155/2022/2608633. eCollection 2022.
To investigate the relationship between the ultrasonographic features of hepatocellular carcinoma (HCC) and the severity of HCC and the expression of tumor suppressor genes PTEN and Tg737, 90 patients with primary liver cancer are selected as the study subjects. The enhancement of liver tumor in arterial phase, portal venous phase, and delayed phase is observed by contrast-enhanced ultrasound (CEUS) before operation, and the echo intensity is compared with that of surrounding liver parenchyma. Immunohistochemistry is used to detect the expression of PTEN and Tg737 in hepatocellular carcinoma and paracancerous tissues. (1) In HCC, CEUS enhancement is characterized by rapid enhancement in arterial phase, enhancement in portal venous phase and delayed phase, and decreased hypoechoic changes. About 78.0% of the stage I-II liver cancer and 85.0% of the stage III-IV liver cancer show rapid enhancement and high echo in the arterial phase; only 8.0% of the stage I-II liver cancer shows moderate echo changes in the portal venous phase, while 32.5% (13/40) stage III-IV liver cancer shows moderate echo changes in the portal venous phase. (2) The positive rates of PTEN in liver cancer tissues and paracancerous tissues are 21.1% (19/90) and 70.0% (63/90), respectively, and the difference is statistically significant. The positive rates of Tg737 in liver cancer tissues and paracancerous tissues are 17.8% (16/90) and 75.6% (68/90), respectively, and the difference is statistically significant. Compared with PTEN and Tg737 negative groups, the ascending slope (RS) and initial elimination time (WT) of PTEN and Tg737 positive groups are significantly higher, indicating that the inflow velocity of contrast medium in the positive group is higher, the outflow time is shorter, and the lesions shows low enhancement rapidly. However, the expression of PTEN and Tg737 had no significant difference in maximal intensity (IMAX), peak time (TTP), and mean transit time (mTT). (3) Correlation analysis shows that the immunohistochemical scores of PTEN and Tg737 are not significantly correlated with IMAX, mTT, and TTP but positively correlated with RS ( = 0.359, < 0.05), suggesting that the positive expressions of PTEN and Tg737 are negatively correlated with the inflow velocity of contrast medium. The immunohistochemical scores of PTEN and Tg737 are negatively correlated with WT, which indicated that the higher the expression intensity of PTEN is, the longer the outflow time of contrast medium is and the slower the outflow of contrast medium is. There is a significant correlation between the expression of PTEN and Tg737 proteins and CEUS parameters in hepatocellular carcinoma.
为了探讨肝细胞癌（HCC）的超声特征与 HCC 严重程度及抑癌基因 PTEN 和 Tg737 表达之间的关系，选择 90 例原发性肝癌患者作为研究对象。术前采用超声造影（CEUS）观察肝肿瘤动脉期、门静脉期和延迟期的增强情况，并与周围肝实质回声强度进行比较。采用免疫组织化学法检测肝癌及癌旁组织中 PTEN 和 Tg737 的表达。（1）在 HCC 中，CEUS 增强的特点是动脉期快速增强、门静脉期和延迟期增强、低回声变化减少。约 78.0%的Ⅰ-Ⅱ期肝癌和 85.0%的Ⅲ-Ⅳ期肝癌在动脉期呈高回声快速增强；只有 8.0%的Ⅰ-Ⅱ期肝癌在门静脉期呈中度回声变化，而 32.5%（13/40）的Ⅲ-Ⅳ期肝癌在门静脉期呈中度回声变化。（2）肝癌组织和癌旁组织中 PTEN 的阳性率分别为 21.1%（19/90）和 70.0%（63/90），差异有统计学意义。肝癌组织和癌旁组织中 Tg737 的阳性率分别为 17.8%（16/90）和 75.6%（68/90），差异有统计学意义。与 PTEN 和 Tg737 阴性组相比，PTEN 和 Tg737 阳性组的上升斜率（RS）和初始消除时间（WT）明显升高，提示阳性组对比剂的流入速度较高，流出时间较短，病变呈快速低增强。然而，PTEN 和 Tg737 的最大强度（IMAX）、峰值时间（TTP）和平均通过时间（mTT）在表达上无显著差异。（3）相关性分析表明，PTEN 和 Tg737 的免疫组织化学评分与 IMAX、mTT 和 TTP 无显著相关性，但与 RS 呈正相关（ = 0.359， < 0.05），提示 PTEN 和 Tg737 的阳性表达与对比剂的流入速度呈负相关。PTEN 和 Tg737 的免疫组织化学评分与 WT 呈负相关，提示 PTEN 表达强度越高，对比剂的流出时间越长，对比剂的流出速度越慢。PTEN 和 Tg737 蛋白在肝细胞癌中的表达与 CEUS 参数之间存在显著相关性。
