术前增强磁共振成像联合临床特征可预测肝细胞癌根治性切除术后的早期复发。
Pre-operative enhanced magnetic resonance imaging combined with clinical features predict early recurrence of hepatocellular carcinoma after radical resection.
作者信息
Chen Jian-Ping, Yang Ri-Hui, Zhang Tian-Hui, Liao Li-An, Guan Yu-Ting, Dai Hai-Yang
机构信息
Department of Intervention, Meizhou People's Hospital, Meizhou 514031, Guangdong Province, China.
Department of Medical Imaging, Meizhou People's Hospital, Meizhou 514031, Guangdong Province, China.
出版信息
World J Gastrointest Oncol. 2024 Apr 15;16(4):1192-1203. doi: 10.4251/wjgo.v16.i4.1192.
BACKGROUND
Indentifying predictive factors for postoperative recurrence of hepatocellular carcinoma (HCC) has great significance for patient prognosis.
AIM
To explore the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) combined with clinical features in predicting early recurrence of HCC after resection.
METHODS
A total of 161 patients with pathologically confirmed HCC were enrolled. The patients were divided into early recurrence and non-early recurrence group based on the follow-up results. The clinical, laboratory, pathological results and Gd-EOB-DTPA enhanced MRI imaging features were analyzed.
RESULTS
Of 161 patients, 73 had early recurrence and 88 were had non-early recurrence. Univariate analysis showed that patient age, gender, serum alpha-fetoprotein level, the Barcelona Clinic Liver Cancer stage, China liver cancer (CNLC) stage, microvascular invasion (MVI), pathological satellite focus, tumor size, tumor number, tumor boundary, tumor capsule, intratumoral necrosis, portal vein tumor thrombus, large vessel invasion, nonperipheral washout, peritumoral enhancement, hepatobiliary phase (HBP)/tumor signal intensity (SI)/peritumoral SI, HBP peritumoral low signal and peritumoral delay enhancement were significantly associated with early recurrence of HCC after operation. Multivariate logistic regression analysis showed that patient age, MVI, CNLC stage, tumor boundary and large vessel invasion were independent predictive factors. External data validation indicated that the area under the curve of the combined predictors was 0.861, suggesting that multivariate logistic regression was a reasonable predictive model for early recurrence of HCC.
CONCLUSION
Gd-EOB-DTPA enhanced MRI combined with clinical features would help predicting the early recurrence of HCC after operation.
背景
识别肝细胞癌（HCC）术后复发的预测因素对患者预后具有重要意义。
目的
探讨钆塞酸二钠（Gd-EOB-DTPA）增强磁共振成像（MRI）联合临床特征在预测HCC切除术后早期复发中的价值。
方法
纳入161例经病理证实的HCC患者。根据随访结果将患者分为早期复发组和非早期复发组。分析临床、实验室、病理结果及Gd-EOB-DTPA增强MRI成像特征。
结果
161例患者中，73例发生早期复发，88例未发生早期复发。单因素分析显示，患者年龄、性别、血清甲胎蛋白水平、巴塞罗那临床肝癌分期、中国肝癌（CNLC）分期、微血管侵犯（MVI）、病理卫星灶、肿瘤大小、肿瘤数量、肿瘤边界、肿瘤包膜、瘤内坏死、门静脉癌栓、大血管侵犯、非周边廓清、瘤周强化、肝胆期（HBP）/肿瘤信号强度（SI）/瘤周SI、HBP瘤周低信号及瘤周延迟强化与HCC术后早期复发显著相关。多因素logistic回归分析显示，患者年龄、MVI、CNLC分期、肿瘤边界及大血管侵犯是独立预测因素。外部数据验证表明，联合预测指标的曲线下面积为0.861，提示多因素logistic回归是HCC早期复发的合理预测模型。
结论
Gd-EOB-DTPA增强MRI联合临床特征有助于预测HCC术后早期复发。
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