AFP异质体阳性肝细胞癌的超声、超声造影特点分析

Imaging features of ultrasound and contrast-enhanced ultrasound in hepatocellular carcinoma with different AFP variant

目的探讨AFP异质体阳性(AFP-L3/AFP≥10%)肝癌的超声及超声造影特点,为AFP异质体阳性肝癌患者预后差提供超声影像学依据。方法随机选择AFP异质体阳性肝癌57例(阳性组)和AFP异质体阴性肝癌30例(阴性组),对比分析2组的超声及超声造影表现,并行统计学分析。结果阳性组病灶最大径≥5 cm 41例(71.9%),多发或弥漫阳性组34例(59.6%),边缘不清或不规则阳性组39例(68.4%),回声不均匀阳性组43例(75.4%),侵犯血管及肝内转移阳性组为31例(56.1%),均显著高于阴性组(P<0.05);病灶呈高回声30例(52.6%),高于阴性组10例(33.3%),而低回声12例(21.1%),低于阴性组12例(40.0%),但2组无统计学差异(P>0.05)。超声造影:阳性组23例表现为"快进快出"16例(69.6%),"快进慢出"7例(30.4%);而阴性组15例表现为"快进快出"5例(33.3%),"快进慢出"10例(66.7%),2组差异具有统计学意义(P<0.05)。结论AFP异质体阳性肝癌超声检查具有肿瘤体积大、浸润性生长、易侵犯血管和发生肝内转移,增强以"快进快出"为主的影像学特点,提示预后不良。

Objective To investigate the imaging features of ultrasound and contrast-enhanced ultrasound of hepatocellu- lar carcinoma（HCC） with a positive AFP-L3. Methods The AFP-L3 positive HCC （n = 57 ） （positive group） and the AFP-L3 negative HCC （ n = 30） （ negative group） were randomly selected, the imaging findings of ultrasound and contrast- enhanced ultrasound were comparatively analyzed in the two groups by statistics. Results In the positive group,41 cases （71.9%） ≥5 cm in the lesions maximum diameter,34 cases （59.6%） in the multiple or diffuse,39 cases（68.4% ） in the unclear or irregular edge ,43 cases （75.4%） in the uneven echo ,22 cases（ 38.6% ） in the invade blood vessels and 11 cases（19.3% ） intrahepatic metastasis in the positive group, marked higher than that of the negative group（ P 〈 O. 05 ）. But 30 cases（52.6% ） and 12 cases（21.1% ） in the lesions＇ high and low echo, the two groups were no signifi- cant difference（P 〉0.05）. ＂Quickly in and quickly out＂ in 16 cases（69.6% ） and ＂quickly in and slow out＂ in 7 cases （30.4%） were showed in contrast-enhanced ultrasound of 23 cases in the positive group, which were difference compared with the negative group （P 〈 0.05）. Conclusion The AFP-L3 positive HCC has the poor prognosis features in ultra- sound and contrast-enhanced ultrasound.