肝细胞癌切除术后早期肝内复发的CT影像学危险因素分析  

Analysis of risk factors for early intrahepatic recurrence of hepatocellular carcinoma after resection by CT imaging

作　　者：张海龙[1] 徐迅[1] 韩冬[1] 冯秋霞 刘希胜[1] ZHANG Hailong;XU Xun;HAN Dong;FENG Qiuxia;LIU Xisheng(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University ,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029

出　　处：《实用放射学杂志》2018年第7期1048-1051,共4页Journal of Practical Radiology

摘　　要：目的 探讨肝细胞癌（HCC）根治性切除术后早期肝内复发的术前CT影像学危险因素。方法 回顾性分析本院收治的120例因HCC行根治性切除术患者的临床及影像学资料，分析术前CT影像学特征与术后早期肝内复发的相关性。结果 术后1年内早期复发71例，对照组（1年后复发或随访期间无复发）49例。单因素分析表明，肿瘤数目、肿瘤直径、肿瘤边界、供血方式、肿瘤坏死、肿瘤周围肝实质动脉期强化、侵犯肝段数目及子灶与术后早期肝内复发相关。多因素分析提示，不光整的肿瘤边界及子灶是影响术后早期肝内复发的独立危险因素。结论 术前CT可用于预测HCC根治性切除术后早期肝内复发。不光整的肿瘤边界及子灶是影响早期肝内复发的最主要危险因素。Objective To investigate the risk factors for the early intrahepatic recurrence of hepatocellular carcinoma （HCC） after curative resection by preoperative CT imaging.Methods A total of 120 patients with HCC undergoing hepatic resection in our institution were included in this study and the clinical and imaging data were analyzed retrospectively.The correlation of preoperative CT imaging features with early postoperative intrahepatic recurrence was analyzed.Results 71 cases showed an early recurrence within 1 year after surgical treatment.The control group included 49 cases ,who underwent recurrence after one year or remained relapse free during the follow-up period.The univariate analysis of variance showed that tumor number, tumor diameter, tumor margin, blood supply, tumoral necrosis,peritumoral hepatic parenchyma enhancement in the arterial phase, number of hepatic segments invaded and satellite lesions were correlated to the early postoperative intrahepatic recurrence. The multivariate analysis revealed that a nowsmooth tumor margin and satellite lesions were independent factors of early postoperative intrahepatic recurrence of HCC. Conclusion Preoperative CT can be used to predict early intrahepatic recurrence of HCC after curative resection. Non smooth tumor margin and satellite lesions are the most important risk factors of early intrahepatic recurrence.

关 键 词：肝细胞癌 肝内复发 计算机体层成像 

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