LI-RADS 与组织病理学特征与单发切除肝癌患者生存的相关性。
Association of LI-RADS and Histopathologic Features with Survival in Patients with Solitary Resected Hepatocellular Carcinoma.
机构信息
From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France.
出版信息
Radiology. 2024 Feb;310(2):e231160. doi: 10.1148/radiol.231160.
Background Both Liver Imaging Reporting and Data System (LI-RADS) and histopathologic features provide prognostic information in patients with hepatocellular carcinoma (HCC), but whether LI-RADS is independently associated with survival is uncertain. Purpose To assess the association of LI-RADS categories and features with survival outcomes in patients with solitary resected HCC. Materials and Methods This retrospective study included patients with solitary resected HCC from three institutions examined with preoperative contrast-enhanced CT and/or MRI between January 2008 and December 2019. Three independent readers evaluated the LI-RADS version 2018 categories and features. Histopathologic features including World Health Organization tumor grade, microvascular and macrovascular invasion, satellite nodules, and tumor capsule were recorded. Overall survival and disease-free survival were assessed with Cox regression models. Marginal effects of nontargetoid features on survival were estimated using propensity score matching. Results A total of 360 patients (median age, 64 years [IQR, 56-70 years]; 280 male patients) were included. At CT and MRI, the LI-RADS LR-M category was associated with increased risk of recurrence (CT: hazard ratio [HR] = 1.83 [95% CI: 1.26, 2.66], = .001; MRI: HR = 2.22 [95% CI: 1.56, 3.16], < .001) and death (CT: HR = 2.47 [95% CI: 1.72, 3.55], < .001; MRI: HR = 1.80 [95% CI: 1.32, 2.46], < .001) independently of histopathologic features. The presence of at least one nontargetoid feature was associated with an increased risk of recurrence (CT: HR = 1.80 [95% CI: 1.36, 2.38], < .001; MRI: HR = 1.93 [95% CI: 1.81, 2.06], < .001) and death (CT: HR = 1.51 [95% CI: 1.10, 2.07], < .010) independently of histopathologic features. In matched samples, recurrence was associated with the presence of at least one nontargetoid feature at CT (HR = 2.06 [95% CI: 1.15, 3.66]; = .02) or MRI (HR = 1.79 [95% CI: 1.01, 3.20]; = .048). Conclusion In patients with solitary resected HCC, LR-M category and nontargetoid features were negatively associated with survival independently of histopathologic characteristics. © RSNA, 2024 See also the editorial by Kartalis and Grigoriadis in this issue.
背景
肝脏成像报告和数据系统（LI-RADS）和组织病理学特征均可为肝细胞癌（HCC）患者提供预后信息，但 LI-RADS 是否与生存独立相关尚不确定。目的：评估 LI-RADS 分类和特征与单发 HCC 患者生存结局的相关性。材料与方法：本回顾性研究纳入了 3 家机构在 2008 年 1 月至 2019 年 12 月期间接受术前对比增强 CT 和/或 MRI 检查的单发 HCC 患者。3 名独立的读者评估了 LI-RADS 版本 2018 的分类和特征。记录组织病理学特征，包括世界卫生组织肿瘤分级、微血管和大血管侵犯、卫星结节和肿瘤包膜。采用 Cox 回归模型评估总生存和无病生存。使用倾向评分匹配估计非靶结节特征对生存的边缘效应。结果：共纳入 360 例患者（中位年龄，64 岁[IQR，56-70 岁]；280 例男性患者）。在 CT 和 MRI 上，LI-RADS LR-M 类别与复发风险增加相关（CT：风险比[HR] = 1.83[95%CI：1.26，2.66]， =.001；MRI：HR = 2.22[95%CI：1.56，3.16]， <.001）和死亡（CT：HR = 2.47[95%CI：1.72，3.55]， <.001；MRI：HR = 1.80[95%CI：1.32，2.46]， <.001）独立于组织病理学特征。存在至少 1 个非靶结节特征与复发风险增加相关（CT：HR = 1.80[95%CI：1.36，2.38]， <.001；MRI：HR = 1.93[95%CI：1.81，2.06]， <.001）和死亡（CT：HR = 1.51[95%CI：1.10，2.07]， <.010）独立于组织病理学特征。在匹配样本中，CT（HR = 2.06[95%CI：1.15，3.66]； =.02）或 MRI（HR = 1.79[95%CI：1.01，3.20]； =.048）上存在至少 1 个非靶结节特征与复发相关。结论：在单发 HCC 患者中，LR-M 类别和非靶结节特征与生存独立相关，与组织病理学特征无关。©RSNA，2024 参见本期 Kartalis 和 Grigoriadis 的社论。
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