肝硬化背景下小肝癌微血管侵犯及复发的CT表现

摘要/Abstract

摘要： 目的观察肝硬化背景下小肝癌(sHCC)微血管侵犯(MVI)及复发的电子计算机断层扫描(CT)影像学表现。方法选取苏州市中西医结合医院2015年6月—2018年6月收治的72例肝硬化背景下sHCC患者作为研究对象,根据患者是否存在MVI分为MVI组(n=32)和非MVI组(n=40),术后随访3年,根据sHCC复发情况分为复发组(n=19)和未复发组(n=53)。于患者术前行CT检查,对比MVI组和非MVI组CT检查结果,以及复发组和未复发组CT检查结果。结果 MVI组包膜完整、包膜缺陷和无包膜患者分别占比28.13%、46.86%和25.00%,非MVI组分别为62.50%、27.50%和10.00%,差异有统计学意义(P<0.05)。MVI组肿瘤边缘增强和肿瘤边缘光滑患者分别占比78.13%和34.38%,非MVI组分别为42.50%和77.50%,差异有统计学意义(P<0.05)。复发组包膜完整、包膜缺陷和无包膜患者分别占比21.43%、46.43%和32.14%,未复发组分别为63.64%、29.55%和6.82%,差异有统计学意义(P<0.05),复发组肿瘤边缘增强和肿瘤边缘光滑患者分别占比92.86%和32.14%,未复发组分别为36.36%和75.00%,差异有统计学意义(P<0.05)。结论术前CT检查对肝硬化背景下sHCC患者MVI和术后复发情况具有较高预测价值。

关键词: 肝硬化, 小肝癌, 微血管侵犯, 复发, 电子计算机断层扫描

Abstract: Objective To investigate the computed tomography (CT) manifestations of microvascular invasion (MVI) and recurrence of small hepatocellular carcinoma (sHCC) under the background of liver cirrhosis. Methods Seventy-two patients with sHCC and cirrhosis admitted to our hospital from June 2015 to June 2018 were selected as the research objects. Patients were divided into a MVI group (n=32) and a non-MVI group (n=40) according to the presence of MVI. All objects were followed up for 3 years after operation, and were divided into a recurrence group (n=19) and a non-recurrence group (n=53) according to the recurrence of sHCC. CT examination was performed before surgery. The results of CT examination between MVI group and non-MVI group were compared. The results of CT examination between recurrence group and non-recurrence group were also compared. Results The proportions of patients with complete capsule, defective capsule and no envelop in MVI group were 28.13%, 46.86% and 25.00%, respectively, while those in non-MVI group were 62.50%, 27.50% and 10.00%, respectively. The differences between the 2 groups were statistically significant (P<0.05). The proportions of patients with enhanced and smooth tumor margins were 78.13%, 34.38% in MVI group, and 42.50%, 77.50% in non-MVI group, respectively. The differences between the 2 groups were statistically significant (P<0.05). The proportions of complete capsule, defective capsule and no envelop in the recurrence group were 21.43%, 46.43% and 32.14%, and those in the non-recurrence group were 63.64%, 29.55% and 6.82%. The differences between the 2 groups were statistically significant (P<0.05). The proportions of patients with enhanced and smooth tumor margins were 92.86%, 32.14% in the recurrence group, and 36.36%, 75.00% in the non-recurrence group, respectively. The differences between the 2 groups were statistically significant (P<0.05). Conclusion Preoperative CT examination has high predictive value for MVI and recurrence of sHCC in patients with cirrhosis.

Key words: Liver cirrhosis, Small hepatocellular carcinoma, Microvascular invasion, Recurrence, Computed tomography

陈小萍, 胡维杰, 王婷婷. 肝硬化背景下小肝癌微血管侵犯及复发的CT表现[J]. 肝脏, 2022, 27(10): 1076-1079.

CHEN Xiao-ping, HU Wei-jie, WANG Ting-ting. CT features of microvascular invasion and recurrence of small hepatocellular carcinoma under the background of liver cirrhosis[J]. Chinese Hepatolgy, 2022, 27(10): 1076-1079.

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