Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China.
Department of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Clin Radiol. 2023 Oct;78(10):e764-e772. doi: 10.1016/j.crad.2023.06.009. Epub 2023 Jun 29.
To explore the value of quantitative image features of gadoxetic acid-enhanced magnetic resonance imaging (MRI) for predicting Gglypican-3 (GPC3) expression of single hepatocellular carcinoma (HCC) ≤3 cm.
One hundred and forty-nine patients with histopathologically confirmed HCC were included retrospectively. Quantitative image features and clinicopathological parameters were analysed. The significant predictors for GPC3 expression were identified using multivariate logistic regression analyses. Nomograms were constructed from the prediction model and the progression-free survival (PFS) rate was evaluated by the Kaplan-Meier method.
The tumour-to-liver signal intensity (SI) ratio on the hepatobiliary phase (HBP; odds ratio [OR] = 0.004; p=0.001), serum alpha-fetoprotein (AFP) > 20 ng/ml (OR=6.175; p<0.001), and non-smooth tumour margin (OR=4.866; p=0.002) were independent significant factors for GPC3 expression. When the three factors were combined, the diagnostic specificity was 97.7% (42/43). The nomogram based on the predictive model performed satisfactorily (C-index: 0.852). Kaplan-Meier curves showed that patients with GPC3-positive HCCs have lower PFS rates than patients with GPC3-negative HCCs (Log-rank test, p=0.006).
The tumour-to-liver SI ratio on the HBP combined with serum AFP >20 ng/ml and non-smooth tumour margin are potential predictive factors for GPC3 expression of small HCC ≤3cm. GPC3 expression is correlated with a poor prognosis in HCC patients.
探讨钆塞酸增强磁共振成像（MRI）定量图像特征预测直径≤3cm 的单个肝细胞癌（HCC）Glypican-3（GPC3）表达的价值。
回顾性纳入 149 例经组织病理学证实的 HCC 患者。分析定量图像特征和临床病理参数。采用多变量逻辑回归分析确定 GPC3 表达的显著预测因子。从预测模型中构建列线图，并通过 Kaplan-Meier 方法评估无进展生存期（PFS）率。
肝胆期（HBP）肿瘤与肝脏的信号强度比（OR=0.004，p=0.001）、血清甲胎蛋白（AFP）>20ng/ml（OR=6.175，p<0.001）和肿瘤边缘不光滑（OR=4.866，p=0.002）是 GPC3 表达的独立显著因素。当这三个因素结合时，诊断特异性为 97.7%（42/43）。基于预测模型的列线图表现良好（C 指数：0.852）。Kaplan-Meier 曲线显示，GPC3 阳性 HCC 患者的 PFS 率低于 GPC3 阴性 HCC 患者（Log-rank 检验，p=0.006）。
HBP 肿瘤与肝脏的 SI 比值结合血清 AFP>20ng/ml 和肿瘤边缘不光滑是预测直径≤3cm 的小 HCC GPC3 表达的潜在预测因子。GPC3 表达与 HCC 患者的不良预后相关。
