Weng Jingfei, Xiao Yuyao, Liu Jing, Liu Xiaohua, He Yuqing, Wu Fei, Ni Xiaoyan, Yang Chun
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
Department of Radiology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, People's Republic of China.
J Hepatocell Carcinoma. 2024 Aug 29;11:1653-1674. doi: 10.2147/JHC.S462979. eCollection 2024.
To study the MRI features (based on LI-RADS) and clinical characteristics of P53-mutated hepatocellular carcinoma (HCC) patients.
This study enrolled 344 patients with histopathologically confirmed HCC (P53-mutated group [n = 196], non-P53-mutated group [n = 148]). We retrospectively evaluated the preoperative MRI features, clinical and pathologic features of the lesions and assigned each lesion according to the LI-RADS. MRI findings, clinical features, and pathologic findings were compared using the Student's t test, χ2 test, and multivariable regression analysis.
Most HCC patients were categorized as LR-5. On multivariate analysis, the Edmondson-Steiner grade (odds ratio, 2.280; 95% CI: 1.268, 4.101; = 0.006) and rim enhancement (odds ratio, 2.517; 95% CI: 1.095, 5.784; = 0.030) were found to be independent variables associated with P53-mutated HCC. In the group of HCC lesions with the largest tumor diameter (LTD) greater than or equal to 10mm and less than or equal to 20mm, enhancing capsule was an independent predictor of P53-mutated HCC (odds ratio, 6.200; 95% CI: 1.116, 34.449; = 0.037). Among the HCC lesions (20 mm ˂ LTD ≤ 50 mm), corona enhancement (odds ratio, 2.102; 95% CI: 1.022, 4.322; = 0.043) and nodule-in-nodule architecture (odds ratio, 2.157; 95% CI: 1.033, 4.504; = 0.041) were found to be independent risk factors for P53 mutation. Among the HCC lesions (50 mm ˂ LTD ≤ 100 mm), diameter (odds ratio, 1.035; 95% CI: 1.001, 1.069; = 0.044) and AFP ≥ 400 (ng/mL) (odds ratio, 3.336; 95% CI: 1.052, 10.577; = 0.041) were found to be independent variables associated with P53-mutated HCC.
Poor differentiation and rim enhancement are potential predictive biomarkers for P53-mutated HCC, while HCCs of different diameters have different risk factors for predicting P53 mutations.
研究P53基因发生突变的肝细胞癌（HCC）患者的MRI特征（基于肝脏影像报告和数据系统（LI-RADS））及临床特征。
本研究纳入344例经组织病理学确诊的HCC患者（P53基因突变组[n = 196]，非P53基因突变组[n = 148]）。我们回顾性评估了病变的术前MRI特征、临床及病理特征，并根据LI-RADS对每个病变进行分类。采用Student's t检验、χ2检验和多变量回归分析对MRI表现、临床特征和病理表现进行比较。
大多数HCC患者被归类为LR-5。多变量分析显示，Edmondson-Steiner分级（比值比，2.280；95%可信区间：1.268, 4.101；P = 0.006）和边缘强化（比值比，2.517；95%可信区间：1.095, 5.784；P = 0.030）是与P53基因突变的HCC相关的独立变量。在最大肿瘤直径（LTD）大于或等于10mm且小于或等于20mm的HCC病变组中，强化包膜是P53基因突变的HCC的独立预测因素（比值比，6.200；95%可信区间：1.116, 34.449；P = 0.037）。在LTD为20mm＜LTD≤50mm的HCC病变中，晕环强化（比值比，2.102；95%可信区间：1.022, 4.322；P = 0.043）和结节内结节结构（比值比，2.157；95%可信区间：1.033, 4.504；P = 0.041）是P53突变的独立危险因素。在LTD为50mm＜LTD≤100mm的HCC病变中，直径（比值比，1.035；95%可信区间：1.001, 1.069；P = 0.044）和甲胎蛋白≥400（ng/mL）（比值比，3.336；95%可信区间：1.052, 10.577；P = 0.041）是与P53基因突变HCC相关的独立变量。
分化差和边缘强化是P53基因突变HCC的潜在预测生物标志物，而不同直径的HCC预测P53突变的危险因素不同。
