Pathological Features of Hepatocellular Carcinoma with Irregular Rim-Like Arterial Phase Enhancement and its Early Recurrence Prognosis Analysis
10.3969/j.issn.1005-5185.2024.10.011
- VernacularTitle:动脉期不规则环形强化肝细胞癌的病理学特征及早期复发预后
- Author:
Lei XU
1
;
Xueqin ZHANG
;
Tao ZHANG
;
Jifeng JIANG
Author Information
1. 南通大学附属南通第三医院影像科,江苏 南通 226000;南通市第三人民医院影像科,江苏 南通 226000
- Keywords:
Carcinoma,hepatocellular;
Magnetic resonance imaging;
Gadoxetic acid;
Prognosis;
Pathology,clinical
- From:
Chinese Journal of Medical Imaging
2024;32(10):1032-1039
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the pathological characteristics of hepatocellular carcinoma(HCC)with irregular rim-like arterial phase enhancement(IRE)using gadoxetic acid-enhanced,and its early recurrence prognostic significance after surgery.Materials and Methods This retrospective study included 131 patients with surgically confirmed HCCs who underwent gadoxetic acid-enhanced MRI from February 2015 to September 2021 in the Third People's Hospital of Nantong.According to the enhancement pattern of gadoxetic acid-enhanced MRI in arterial phase,HCC were divided into IRE-HCC and non-IRE-HCC.Clinical,pathological and imaging characteristics were compared between IRE-HCC and non-IRE-HCC.Logistic regression analyses were performed to identify clinical,pathological and imaging features associated with IRE-HCC.Early recurrence(within 2 years)was evaluated by using Kaplan-Meier analysis.Cox regression analysis was performed to determine independent predictors of early recurrence.Results Cytokeratin 19(CK19)(OR=9.027,95%CI 2.533-32.170,P=0.001),microvascular invasion(OR=3.606,95%CI 1.024-12.701,P=0.046)and diffusion weighted imaging target signs(OR=10.370,95%CI 3.046-35.303,P=0.000)were independent predictors for IRE-HCC.The 2-year cumulative recurrence-free survival rate postoperative of IRE-HCC was 24.1%,which was significantly shorter than that of non-IRE-HCC(55.9%,χ2=19.971,P=0.000).Microvascular invasion(HR=2.206,95%CI 1.152-4.226,P=0.017)and IRE(HR=2.454,95%CI 1.408-4.275,P=0.002)were independent predictors of early postoperative recurrence of HCC.Conclusion IRE-HCC are associated with CK19,microvascular invasion and diffusion weighted imaging target signs,and have a high recurrence rate and poor prognosis in the early postoperative period.
