摘要
目的:通过分析原发性肝细胞癌(HCC)分化程度、Ki-67和p53表达以及病灶大小对超声造影(CEUS)廓清时间的影响,探讨CEUS对HCC病理特征的预测价值。方法:回顾性分析经病理证实的229例患者共246个HCC病灶的CEUS廓清时间。按病理分化程度将病灶分为高分化和中低分化两组;按阳性百分比将免疫组化参数Ki-67及p53分为阴性组和阳性组;按最大直径将病灶分为3组:a组(≤3 cm)、b组(>3~5 cm)、c组(>5 cm)。采用χ2检验比较不同分化程度、Ki-67及p53表达和不同直径的HCC超声造影廓清时间的差异。结果:(1)不同分化程度HCC的廓清时间差异有统计学意义(P<0.05),中低分化HCC多在60 s前廓清(46.8%),高分化HCC多在120~300 s廓清(34.8%)。(2)不同Ki-67表达HCC的廓清时间差异总体无统计学意义(P>0.05)。(3)不同p53表达HCC的廓清时间总体差异无统计学意义(P>0.05)。组间两两比较显示,不同p53表达HCC在120~300 s廓清的差异有统计学意义,与阳性组相比,p53阴性组在120~300 s廓清的比例更大(30.2%vs 14.1%)。(4)不同直径HCC的廓清时间差异总体无统计学意义(P>0.05)。与b组和c组相比,a组未廓清的比例更大(a组vs b组vs c组:15.1%vs 5.2%vs 5.3%)。结论:CEUS廓清时间在不同分化程度和不同p53表达的HCC中存在差异,表明CEUS对HCC的病理特征具有一定的预测价值。
Objective:To investigate the predictive value of contrast-enhanced ultrasound(CEUS)for the pathological features of primary hepatocellular carcinoma(HCC),we analyzed the relationship of the wash-out time of CEUS and the pathologi-cal features of HCC,including differentiation degree,expression of Ki-67 and p53,and lesion size.Methods:This study included 246 HCC lesions in 229 patients,which was diagnosed by pathology.The wash-out time of CEUS was analyzed.Ac-cording to the differentiation degree,the lesions were divided into high differentiation and medium-low differentiation groups.According to positive percentage of Ki-67 and p53,the lesions were divided into negative and positive groups.According to the diameter,the lesions were divided into three groups:a(≤3 cm),b(>3~5 cm),and c(>5 cm)groups.Comparisons of the wash-out time in different groups were performed by Chi-square test.Results:(1)There was significant difference in wash-out time of HCC between high differentiation and medium-low differentiation groups(P<0.05).The wash-out time of medium-low differentiation HCC was mostly before 60 s(46.8%),and that of high differentiation HCC was mostly in 120~300 s(34.8%).(2)There was no significant difference in wash-out time of HCC between Ki-67 postive and Ki-67 negative groups(P>0.05).(3)There was no significant difference in wash-out time of HCC between p53 positive and p53 negative groups(P>0.05).Compared to p53 positive group,the percentage of wash-out time in 120~300 s was higher in the p53 negative group(30.2%vs14.1%).(4)There was no significant difference in the wash-out of HCC among different diameters(P>0.05).Compared with b group and c group,a group had a higher proportion of no wash-out(a group vs b group vs c group,15.1%vs 5.2%vs5.3%).Conclusions:There were significant differences in wash-out time of HCC with different differentiation degrees,as well as with different p53 expression,which suggest that CEUS has certain predictive value for the pathological features of HCC.
作者
苏梦雪
唐少珊
徐碧莹
陈鹏
李想
吴星霓
李梓楠
SU Meng-xue;TANG Shao-shan;XU Bi-ying;CHEN Peng;LI Xiang;WU Xing-ni;LI Zi-nan(Department of Ultrasound,Shengjing Hospital of China Medical University,Shenyang 110004,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2022年第11期784-787,793,共5页
Journal of China Clinic Medical Imaging
关键词
癌
肝细胞
超声检查
血管造影术
Carcinoma,Hepatocellular
Ultrasonography
Angiography