Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuzhong District, Chongqing 400016, PR China.
Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, PR China.
Eur J Radiol. 2024 Oct;179:111681. doi: 10.1016/j.ejrad.2024.111681. Epub 2024 Aug 12.
To explore the capability of preoperative CT imaging features, in combination with clinical indicators, for predicting vessels that encapsulate tumor clusters (VETC) pattern and prognosis in hepatocellular carcinoma (HCC).
From January 2015 to May 2022, patients with HCC who underwent curative resection and preoperative enhanced CT were retrospectively included. Clinical indicators and imaging featuresassociated with the VETC pattern were determined by logistic regression analyses. The early recurrence (ER) rate was determined using the Kaplan-Meier survival curve. Factors associated with ER after surgical resection were identified by Cox regression analyses.
A total of 243 patients with HCCwere evaluated. The total bilirubin > 17.1 μmol/L (odds ratio [OR] 3.43, 95 % Confidence Interval [CI] 1.70, 6.91, p = 0.001), serum α-fetoprotein > 100 ng/mL (OR 2.41, 95 % CI 1.25, 4.67, p = 0.009), intratumor artery (IA) (OR 2.00, 95 % CI 1.04, 3.86,p = 0.039) and arterial peritumoral enhancement (OR 2.60, 95 % CI 1.13, 5.96, p = 0.025) were independent risk factors for VETC-HCC. The VETCstatus andCT feature ofIA were associated with an increased risk of recurrence, with a shorter median RFS, compared to those without these factors (p < 0.001 and p = 0.019, respectively). In multivariable Cox regression analysis, the VETC(hazard ratio [HR] 2.60, 95 % CI 1.66, 4.09, p < 0.001), morphological patterns of confluent multinodular growth (HR 1.79, 95 % CI 1.10, 2.91,p = 0.019), the number of the tumors (≥2) (HR 2.69, 95 % CI 1.56, 4.65, p < 0.001), and the IA (HR 1.73, 95 % CI 1.12, 2.66, p = 0.013) were independent predictors of ER in patients with HCC after surgical resection.
Preoperative CT features combined with clinical indicators could predict VETC pattern, and the CT features, along with VETC status, were of prognostic significance for early postoperative recurrence in patients with HCC.
Preoperative CT features combined with clinical indicators could predict VETC pattern, and the CT features, along with VETC status, were of prognostic significance for early recurrence in patients with HCC after surgical resection.
探讨术前 CT 影像学特征联合临床指标预测肝癌包膜内血管包裹肿瘤簇（VETC）模式和预后的能力。
回顾性纳入 2015 年 1 月至 2022 年 5 月接受根治性切除术且术前行增强 CT 的肝癌患者。通过逻辑回归分析确定与 VETC 模式相关的临床指标和影像学特征。使用 Kaplan-Meier 生存曲线确定早期复发（ER）率。通过 Cox 回归分析确定手术切除后与 ER 相关的因素。
共评估了 243 例 HCC 患者。总胆红素>17.1μmol/L（比值比[OR]3.43，95%置信区间[CI]1.70，6.91，p=0.001）、血清甲胎蛋白>100ng/mL（OR 2.41，95%CI 1.25，4.67，p=0.009）、肿瘤内动脉（IA）（OR 2.00，95%CI 1.04，3.86，p=0.039）和动脉肿瘤周增强（OR 2.60，95%CI 1.13，5.96，p=0.025）是 VETC-HCC 的独立危险因素。VETC 状态和 IA 的 CT 特征与复发风险增加相关，中位 RFS 更短，与无这些因素的患者相比（p<0.001 和 p=0.019）。多变量 Cox 回归分析显示，VETC（风险比[HR]2.60，95%CI 1.66，4.09，p<0.001）、融合性多结节生长的形态模式（HR 1.79，95%CI 1.10，2.91，p=0.019）、肿瘤数量（≥2）（HR 2.69，95%CI 1.56，4.65，p<0.001）和 IA（HR 1.73，95%CI 1.12，2.66，p=0.013）是肝癌患者术后 ER 的独立预测因子。
术前 CT 特征联合临床指标可预测 VETC 模式，CT 特征联合 VETC 状态对肝癌患者术后早期复发具有预后意义。
术前 CT 特征联合临床指标可预测 VETC 模式，CT 特征联合 VETC 状态对肝癌患者术后早期复发具有预后意义。
