摘要
目的探讨MRI增强扫描参数与肝细胞癌(hepatocellular carcinoma,HCC)患者的肿瘤组织学分级和微血管浸润(microvascular invasion,MVI)关系。方法回顾性收集2019年1月至2022年12月期间接受MRI增强扫描的181例患者临床资料。HCC分化程度根据Edmondson-Steiner分级分为低级别肿瘤(Ⅰ、Ⅱ级)和高级别肿瘤(Ⅲ和Ⅳ级)。根据MVI发生情况分为MVI阳性组和MVI阴性组。使用多因素Logistic回归模型分析影响MVI和组织学高级别分化的独立危险因素。结果MVI阳性组118例和MVI阴性组63例,组织学分级低级别组51例和高级别组130例。AFP水平在MVI阳性组和阴性组、低级别组和高级别组中均存在统计学意义(P=0.002和0.041)。而高级别组肝硬化患者比例较低(P=0.015)。多因素Logistic回归结果可见存在多个肿瘤(OR=4.252,P=0.000),肿瘤直径≥5cm(OR=5.167,P=0.000),动脉期瘤周强化(OR=5.156,P=0.000),肝胆期瘤周低信号(OR=4.163,P=0.000)是HCC患者发生MVI的独立危险因素,而包膜完整(OR=0.295,P=0.000)是发生MVI的保护因素。肝硬化(OR=0.873,P=0.000)包膜完整(OR=0.283,P=0.000)是保护因素,而多个肿瘤(OR=5.116,P=0.000),肿瘤形状为分叶状(OR=5.276,P=0.000)是HCC患者发生病理组织学高级别病变的独立危险因素。结论术前增强MRI成像参数与HCC患者MVI和组织学分化程度具有一定相关性,对于其预测价值值得进一步研究。
Objective To investigate the relationship between MRI enhanced scanning parameters and tumor histological grading and microvascular invasion(MVI)in patients with hepatocellular carcinoma(HCC).Methods Clinical data of 181 patients who underwent enhanced MRI scans from January 2019 to December 2022 were retrospectively collected.They were divided into the low-grade tumors(GradeⅠ,Ⅱ)and the high-grade tumors(GradeⅢandⅣ)based on Edmondson-Steiner Grading.And also were divide into the MVI positive group and the MVI negative group based on the occurrence of MVI.Multivariate logistic regression model were used to analyze independent risk factors of MVI and highgrade histological differentiation.Results There were 118 cases in the MVI positive group and 163 cases in the MVI negative group,as well as 51 cases in the low-grade group and 130 cases in the high-grade group.The AFP levels were statistically significant in the MVI positive and the MVI negative groups,as well as in the low-grade and high-grade groups(P=0.002 and 0.041).The proportion of patients with liver cirrhosis in the high-grade group is relatively low(P=0.015).The results of multivariate logistic regression showed that the presence of multiple tumors(OR=4.252,P=0.000),tumor diameter≥5cm(OR=5.167,P=0.000),arterial phase peritumoral enhancement(OR=5.156,P=0.000),and low signal intensity(OR=4.163,P=0.000)were independent risk factors for MVI in HCC patients,while intact capsule(OR=0.295,P=0.000)was a protective factor for MVI.Liver cirrhosis(OR=0.873,P=0.000)with intact capsule(OR=0.283,P=0.000)is a protective factor,while multiple tumors(OR=5.116,P=0.000)with lobulated tumor shape(OR=5.276,P=0.000)are independent risk factors for highgrade histopathological changes in HCC patients.Conclusion There is a certain correlation between preoperative enhanced MRI imaging parameters and MVI and histological differentiation in HCC patients,and its predictive value is worth further research.
作者
刘刚
林伟文
何海奇
林毅
LIU Gang;LIN Wei-wen;HE Hai-qi;LIN Yi(Department of Radiological Diagnosis,The 909th Hospital Dongnan Hospital of XiamenUniversity,Zhangzhou 363000,Fujian Province,China)
出处
《中国CT和MRI杂志》
2024年第2期98-101,共4页
Chinese Journal of CT and MRI
基金
福建省医学创新课题项目(2018-CX-35)。
关键词
肝细胞癌
微血管浸润
组织学分级
核磁共振成像
Hepatocellular Carcinoma
Microvascular Infiltration
Histological Grading
Magnetic Resonance Imaging
