结直肠癌肝转移瘤影像特征与病理关系及预后评价

Relationship between imaging features and pathology of liver metastases from colorectal cancer and effects on prognostic evaluation

目的:分析结直肠肝转移瘤(CRCLM)增强CT影像特征与组织病理生长方式(HGP)关系,评估二者对患者预后的价值。方法:回顾性分析67例经术后病理证实为CRCLM的患者,术前均接受肝脏平扫及三期(动脉期、门静脉期和延迟期)增强CT扫描检查,采用Logistic回归模型研究CRCLM影像特征与病灶HGP关系;采用Cox风险比例模型分析CRCLM影像特征、HGP对患者总生存时间(OS)预测作用。结果:CRCLM影像特征中环形强化、强化时期是病灶HGP独立影响因素,OR值分别为(16.38(95%CI:1.022,262.5),P=0.048),(4.345(95%CI:1.087,17.36),P=0.038);CRCLM环形强化、病灶HGP是患者OS独立影响因素,HR值分别为(1.976(95%CI:0.461,1.178),P=0.013),(0.310(95%CI:0.132,0.725),P=0.007)。结论:CRCLM影像特征与病灶HGP相关且二者对于患者预后具有临床指导意义。

Objective:To analyze the relationship between enhanced CT imaging features and histopathological growth patterns(HGP)from colorectal cancer liver metastasis(CRCLM),and to evaluate their prognostic value.Methods:Sixty-seven patients with liver metastases from colorectal cancer confirmed by pathology after operation were retrospectively analyzed.All pa-tients underwent plain liver scan and three-phase enhanced CT scan(arterial phase,portal venous phase and delayed phase)before operation.Logistic regression model was used to study the relationship between CRCLM image features and lesion HGP,and Cox risk ratio model was used to analyze CRCLM image features and the predictive effect of HGP on overall survival(OS).Results:Ring enhancement and enhancement period were the independent influencing factors of HGP in CRCLM imaging features,and the OR values were(16.38(95%CI:1.022,262.5),P=0.048),(4.345(95%CI:1.087,17.36),P=0.038).CRCLM ring enhancement and HGP were independent influencing factors of OS in patients,and HR values were(1.976(95%CI:0.461,1.178),P=0.013),(0.310(95%CI:0.132,0.725),P=0.007),respectively.Conclusion:The imaging features of CRCLM are related to the HGP of the lesions,and both of them have good clinical significance for the prognosis of the patients.