超声造影肝脏影像数据和报告系统分类与肝细胞癌分化程度及Ki-67指数的相关性分析

Correlation analysis of contrast-enhanced ultrasound Liver Imaging Reporting and Data System classification with hepatocellular carcinoma differentiation and Ki-67 index

目的探讨不同超声造影(CEUS)肝脏影像数据和报告系统(LI-RADS)类别与肝细胞癌(HCC)分化程度及Ki-67指数相关性。方法采用回顾性病例研究,纳入分析中国CEUS数据库中2017年12月至2020年12月共208例HCC患者(208个病灶)的临床和影像学资料,根据美国放射学会提出的CEUS LI-RADS(V2017)对病灶分类。以组织病理学诊断结果为金标准,评估HCC的分化程度及Ki-67指数在CEUS LI-RADS不同类别中分布是否存在差异,并采用Kendall′s tau-b相关系数检验分析CEUS LI-RADS类别与肿瘤分化程度及Ki-67指数的相关性。结果不同CEUS LI-RADS类别的HCC之间分化程度及Ki-67指数的分布差异有统计学意义(P<0.001,P=0.009),CEUS LI-RADS M类HCC更容易呈低分化且表现出更高的Ki-67指数。CEUS LI-RADS类别与肿瘤分化程度呈负相关(tau-b=-0.250,P<0.001),与Ki-67指数呈正相关(tau-b=0.178,P=0.002),即CEUS LI-RADS类别越高,肿瘤的分化程度越低且Ki-67指数越高。结论不同CEUS LI-RADS类别与HCC分化程度及Ki-67指数存在相关性。

Objective To investigate the correlation of hepatocellular carcinoma(HCC)classified by contrast-enhanced ultrasound(CEUS)Liver Imaging Data and Report System(LI-RADS)with differentiation degree and Ki-67 index.Methods A multicenter,retrospective study was conducted.The clinical and CEUS imaging data of 208 patients with 208 HCC lesions from December 2017 to December 2020 in China CEUS database were included and analyzed.According to the CEUS LI-RADS version 2017 proposed by the American College of Radiology,the HCC was classified.The diagnosis and pathological information of all lesions were confirmed by pathology.The differentiation degree of HCC and the distribution of Ki-67 index in different LI-RADS categories were evaluated,and their correlation was analyzed.Results The degree of differentiation and Ki-67 index among HCC of different CEUS LI-RADS were statistically significant(P<0.001,P=0.009).LI-RADS M HCC was more likely to be poorly differentiated and showed a higher Ki-67 index.The category of LI-RADS was positively correlated with the degree of tumor differentiation(tau-b=-0.250,P<0.001)and the Ki-67 index(tau-b=0.178,P=0.002),that is,the higher the category of LI-RADS,the lower differentiation degree and the higher the Ki-67.Conclusions The CEUS LI-RADS classification of HCC is correlating with the degree of differentiation and Ki-67 index.