肝细胞性肝癌超声影像学表现与病理特征及预后的关系
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摘要
目的分析肝细胞性肝癌超声影像学表现及病理特征,并探讨其间关联以及与转移预后之间的联系。方法研究选取肝细胞性肝癌患者159例进行研究,分析肝细胞性肝癌超声影像学表现及病理特征,同时分析治疗后1年患者转移预后的发生情况,并且分析其间关联。研究使用SPSS 20. 0行统计分析。结果不同病理分级患者中的肿瘤增强开始时间、肿瘤增强变化时间以及肿瘤增强变低时间差别均有统计学意义(P <0. 05)。动脉期Ⅰ级病理分级患者高增强比例最高,占88. 46%;Ⅱ级患者高增强比例也是最高;而Ⅲ级和Ⅳ级患者均表现为高增强,构成比例均达到100%。门脉期Ⅰ级病理分级患者低增强比例最高;Ⅱ级患者低增强比例也是最高;Ⅲ级患者也表现为低增强比例为78. 57%;Ⅳ级患者均表现为低增强,构成比例达到100%。延迟期Ⅰ级病理分级患者低增强比例最高;Ⅱ级患者低增强比例也是最高;Ⅲ级患者也表现为低增强比例为97. 26%;Ⅳ级患者均表现为低增强,构成比例均达到100%。回归分析提示,病理分级高、肿瘤增强开始时间长、动脉期高增强、门脉期低增强以及延迟期低增强,均表现为发生转移的危险因素。结论不同病理特征的肝癌患者具有不同的影像学特征;病理分级高、肿瘤增强开始时间长、动脉期高增强、门脉期低增强以及延迟期低增强均表现为发生转移的危险因素。
Objective To analyze and discuss the ultrasonographic features and pathological features of hepatocellular carcinoma( HCC) and to analyze the relationship between them. Methods A total of 159 patients with hepatocellular carcinoma diagnosed in our hospital were selected for the study. The imaging features and pathological features of hepatocellular carcinoma were analyzed. The incidence of metastasis and prognosis were collected after one year of follow-up and analyzed. The study used SPSS 20. 0 line statistical analysis. Results In this study,we compared the time of tumor enhancement and tumor enhancement.The results suggest that the time of tumor enhancement,the time of tumor enhancement,the time of tumor enhancement and the time of tumor enhancement in different pathological grading patients have statistical significance,P < 0. 05; Patients with grade Ⅰpathological grading had the highest proportion of high enhancement,accounting for 88. 46%. Patients with grade Ⅱ showed the highest rate of high enhancement. Patients with grade Ⅲ and Ⅳ showed high enhancement with 100% of the total. Grade Ⅰ patients with pathological grade of portal hypertension low enhancement rate was the highest; Ⅱ-level patients with low enhancement ratio is also the highest; Ⅲ-level patients also showed a low enhancement ratio of 78. 57%; Ⅳ-level patients showed low enhancement,the composition ratio reached 100%. The patients with grade Ⅰ pathological grading had the highest rate of low enhancement,the patients with grade Ⅱ showed the highest rate of low enhancement,the patients with grade Ⅲ showed low enhancement with rate of 97. 26%,and the patients with grade Ⅳ showed low enhancement with the proportion of 100%. Regression analysis showed that high pathological grade,long tumor start time,high arterial phase,low portal phase and low delay phase were the risk factors of metastasis. Conclusion HCC patients with different pathological features have different imaging features. High pathological grade,long tumor initiation,high arterial phase,low portal phase,and low phase delay are the risk factors of metastasis.
Objective To analyze and discuss the ultrasonographic features and pathological features of hepatocellular carcinoma( HCC) and to analyze the relationship between them. Methods A total of 159 patients with hepatocellular carcinoma diagnosed in our hospital were selected for the study. The imaging features and pathological features of hepatocellular carcinoma were analyzed. The incidence of metastasis and prognosis were collected after one year of follow-up and analyzed. The study used SPSS 20. 0 line statistical analysis. Results In this study,we compared the time of tumor enhancement and tumor enhancement.The results suggest that the time of tumor enhancement,the time of tumor enhancement,the time of tumor enhancement and the time of tumor enhancement in different pathological grading patients have statistical significance,P < 0. 05; Patients with grade Ⅰpathological grading had the highest proportion of high enhancement,accounting for 88. 46%. Patients with grade Ⅱ showed the highest rate of high enhancement. Patients with grade Ⅲ and Ⅳ showed high enhancement with 100% of the total. Grade Ⅰ patients with pathological grade of portal hypertension low enhancement rate was the highest; Ⅱ-level patients with low enhancement ratio is also the highest; Ⅲ-level patients also showed a low enhancement ratio of 78. 57%; Ⅳ-level patients showed low enhancement,the composition ratio reached 100%. The patients with grade Ⅰ pathological grading had the highest rate of low enhancement,the patients with grade Ⅱ showed the highest rate of low enhancement,the patients with grade Ⅲ showed low enhancement with rate of 97. 26%,and the patients with grade Ⅳ showed low enhancement with the proportion of 100%. Regression analysis showed that high pathological grade,long tumor start time,high arterial phase,low portal phase and low delay phase were the risk factors of metastasis. Conclusion HCC patients with different pathological features have different imaging features. High pathological grade,long tumor initiation,high arterial phase,low portal phase,and low phase delay are the risk factors of metastasis.
引文
[1]王克锋,欧亚非,张伟伟,等.超声造影引导下经皮经肝注射无水乙醇治疗肝癌残留灶的临床观察〔J〕.临床超声医学杂志,2017,19(1):68-69.
[2]王钢,赵利锋,雷达,等.手术治疗原发性肝癌患者生存率的影响因素分析〔J〕.实用癌症杂志,2015,30(4):606-608.
[3]彭红艳,余松远,贺飞,等.超声造影评价特殊部位肝癌微波消融联合补充无水乙醇治疗的应用价值〔J〕.中国超声医学杂志,2017,33(3):241-244.
[4]潘嘉敏,程美清,曾丹,等.常规超声与超声造影对良恶性肾囊性肿物诊断价值的比较〔J〕.临床超声医学杂志,2017,19(1):7-9.
[5]丁建民,周燕,王彦冬,等.超声造影对肝硬化背景下早期肝癌与增生结节鉴别诊断〔J〕.中国超声医学杂志,2017,33(8):711-714.
[6]雒大健,张志勇,全艳,等.超声造影对典型与非典型肝癌的鉴别诊断〔J〕.实用癌症杂志,2017,32(4):571-574.
[7]于馨,曹军英,高越,等.超声造影引导在肝占位性病变穿刺活检中应用价值〔J〕.临床军医杂志,2017,45(5):466-468.
[8]吕品.原发性肝癌与肝嗜铬细胞瘤B超影像学的差异性〔J〕.实用癌症杂志,2016,31(7):1114-1116.
[9]余秀华,李彩云,施红,等.常规超声联合超声造影成像对宫颈癌诊断及分期初步研究〔J〕.临床军医杂志,2017,45(1):60-63.
[10]周婷,曹荔,陆小燕,等.超声与MRI联合评估胎儿颅后窝池增宽的临床应用〔J〕.东南大学学报(医学版),2017,36(1):62-66.
[11]王瑞涛,李建波,张灵强,等.原发性肝癌淋巴结转移临床病理特点与预后的关系〔J〕.中华消化外科杂志,2015,14(2):127-132.
[12]白韬,杜潇,卜君,等.乳腺超声光散射成像联合血清CA15-3、CEA检测在乳腺肿瘤中的诊断价值〔J〕.标记免疫分析与临床,2017,24(7):762-765.
[13]王战业,夏炳兰,王翠梅,等.高频超声对外周神经肿瘤的诊断价值〔J〕.东南大学学报(医学版),2017,36(1):94-96.
[14]汪素莉.颈动脉超声下初发性和复发性脑梗死患者颈动脉粥样硬化的表现对比〔J〕.检验医学与临床,2017,14(6):872-874.
[15]程邵洪,郭小平.超声引导下腹横肌平面阻滞对剖宫产术后镇痛的影响〔J〕.检验医学与临床,2017,14(21):3214-3218.
[16]李宾,胡万宁.三维立体定位CT引导下~(125)I粒子植入治疗原发性肝癌的疗效及安全性〔J〕.标记免疫分析与临床,2016,23(11):1294-1298.
[2]王钢,赵利锋,雷达,等.手术治疗原发性肝癌患者生存率的影响因素分析〔J〕.实用癌症杂志,2015,30(4):606-608.
[3]彭红艳,余松远,贺飞,等.超声造影评价特殊部位肝癌微波消融联合补充无水乙醇治疗的应用价值〔J〕.中国超声医学杂志,2017,33(3):241-244.
[4]潘嘉敏,程美清,曾丹,等.常规超声与超声造影对良恶性肾囊性肿物诊断价值的比较〔J〕.临床超声医学杂志,2017,19(1):7-9.
[5]丁建民,周燕,王彦冬,等.超声造影对肝硬化背景下早期肝癌与增生结节鉴别诊断〔J〕.中国超声医学杂志,2017,33(8):711-714.
[6]雒大健,张志勇,全艳,等.超声造影对典型与非典型肝癌的鉴别诊断〔J〕.实用癌症杂志,2017,32(4):571-574.
[7]于馨,曹军英,高越,等.超声造影引导在肝占位性病变穿刺活检中应用价值〔J〕.临床军医杂志,2017,45(5):466-468.
[8]吕品.原发性肝癌与肝嗜铬细胞瘤B超影像学的差异性〔J〕.实用癌症杂志,2016,31(7):1114-1116.
[9]余秀华,李彩云,施红,等.常规超声联合超声造影成像对宫颈癌诊断及分期初步研究〔J〕.临床军医杂志,2017,45(1):60-63.
[10]周婷,曹荔,陆小燕,等.超声与MRI联合评估胎儿颅后窝池增宽的临床应用〔J〕.东南大学学报(医学版),2017,36(1):62-66.
[11]王瑞涛,李建波,张灵强,等.原发性肝癌淋巴结转移临床病理特点与预后的关系〔J〕.中华消化外科杂志,2015,14(2):127-132.
[12]白韬,杜潇,卜君,等.乳腺超声光散射成像联合血清CA15-3、CEA检测在乳腺肿瘤中的诊断价值〔J〕.标记免疫分析与临床,2017,24(7):762-765.
[13]王战业,夏炳兰,王翠梅,等.高频超声对外周神经肿瘤的诊断价值〔J〕.东南大学学报(医学版),2017,36(1):94-96.
[14]汪素莉.颈动脉超声下初发性和复发性脑梗死患者颈动脉粥样硬化的表现对比〔J〕.检验医学与临床,2017,14(6):872-874.
[15]程邵洪,郭小平.超声引导下腹横肌平面阻滞对剖宫产术后镇痛的影响〔J〕.检验医学与临床,2017,14(21):3214-3218.
[16]李宾,胡万宁.三维立体定位CT引导下~(125)I粒子植入治疗原发性肝癌的疗效及安全性〔J〕.标记免疫分析与临床,2016,23(11):1294-1298.
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