肝细胞癌肝内早期复发转移CT表现影响因素研究  

Study of risk factors for early interhepatic recurrence and metastasis of hepatocellular carcinoma on CT findings

作　　者：高顺禹[1] 张晓鹏[1] 崔湧[1] 孙应实[1] 唐磊[1] 李晓婷[1] 单军[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《实用放射学杂志》2014年第5期783-785,896,共4页Journal of Practical Radiology

基　　金：国家重点基础研究发展计划（973计划）项目（2011CB707705）;国家自然科学基金项目（81371715）;北京市科学技术委员会：首都特色临床应用研究（Z121107001012115）.

摘　　要：目的：探讨肝细胞癌（hepatocellular carcinoma,HCC）肝内早期复发转移的治疗前增强 CT 表现影响因素。方法回顾性收集2003-07-2009-01在本院收治的115例 HCC 患者的临床及治疗前多期增强 CT 资料,所有病例均有规律影像学随访结果。测量记录 CT 征象及其肝内复发转移情况,经单因素方差分析、卡方检验,对影响 HCC 早期复发转移的 CT 表现因素进行初筛。将有统计学意义的指标行 Logistic 回归多因素分析,以 P 〈0.05为有统计学意义。结果本组 HCC 患者肝内早期复发转移率为58.26%。经单因素分析显示 HCC 病灶大小、部位、范围、包膜、子灶、血管侵犯、动静脉瘘、坏死对 HCC 肝内早期复发转移有影响（P 〈0.05）。Logistic 回归多因素分析结果表明病灶大小、子灶、血管侵犯、包膜是影响 HCC 早期复发的独立因素（P =0.031,0.005、0.037、0.048）。结论 CT 表现同 HCC 肝内早期复发转移密切相关,肿瘤较大、伴有子灶、无完整包膜和伴有血管侵犯提示患者易于早期复发转移。Objective To explore the risk factors for early interhepatic recurrence and metastasis of hepatocellular carcinoma （HCC）on CT imaging before treatment.Methods 1 1 5 patients suffered from HCC from July 2003 to January 2009 were retrospec-tively enrolled for reviewing their clinical characteristics and CT signs.The status of metastasis and/or recurrence was followed reg-ularly.Signs on pre-treatment enhanced CT images were measured and analyzed.Analysis of variance and independent sampler t test were applied for Univariate survival analysis.Then multivariate analysis was carried out by the Logistic regression,Lon rank meth-od,and p-value 〈 0.05 was defined to be statistically significant.Results The early interhepatic recurrence and metastasis rate of the study group was 58.26%.With univariate analysis,tumor size,location,extent,capsule,satellite nodule,vascular invasion, AVM and necrosis were the risk factors for early recurrence and metastasis of HCC on pre-treatment enhanced CT imaging （P〈0.05）.Multi-variable Logistic regression analysis showed that tumor size,satellite nodule,vascular invasion capsule and were independently significant CT signs for early interhepatic recurrence and metastasis of HCC （P =0.031,0.005、0.037、0.048）.Conclusion Pre-treat-ment enhanced CT imaging with HCC was closely related to early interhepatic recurrence and metastasis of the tumor.A tumor of larger size,with satellite nodules,without complete capsule and vascular invasion on CT may predict a tendency to early interhepatic recurrence and metastasis of HCC.

关 键 词：肝细胞癌 计算机体层成像 预后 复发 转移 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]