假包膜征对乙肝肝硬化背景下小肝癌的诊断价值  

Diagnostic value of pseudocapsule sign for small hepatocellular carcinoma in patients with hepatitis B cirrhosis

作　　者：李若旭[1] 杨堉杰 邢卫红[1] 候懿瑄 杨明 董发发 LI Ruoxu;YANG Yujie;XING Weihong;HOU Yixuan(Department of Radiology,Shijiazhuang Fifth Hospital,Hebei,Shijiazhuang 050021,China)

机构地区：[1]河北省石家庄市第五医院放射科,050021

出　　处：《河北医药》2023年第3期399-401,405,共4页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20210170)。

摘　　要：目的探讨假包膜征与乙肝肝硬化背景下肝细胞肝癌的大小、AFP及病理分化程度的相关性。方法回顾性分析103例乙肝肝硬化伴发肝癌患者的临床及影像学资料,根据磁共振平扫及强化扫描的影像特征将所有病例分为包膜组和无包膜组,比较2组间肿瘤直径、甲胎蛋白(AFP)及病理分化差异。结果共检出79枚小肝癌,其中高分化14枚、中分化65枚;显示有假包膜征小肝癌32枚(包膜完整18枚,包膜不完整14枚),无包膜小肝癌47枚。通过组间比较包膜组病灶直径为1.85(1.50,2.30)cm,无包膜组病灶直径为1.50(1.10,1.90)cm,2组总体病灶直径分布存在统计差异(z=2.53,P=0.001);包膜组与无包膜组AFP及病理分化程度总体分布差异无统计学(P>0.05)。结论磁共振增强扫描门脉期及平衡期对肝癌假包膜显示率较高,肿瘤大小与癌灶假包膜存在相关性。Objective To investigate the correlation between pseudocapsule sign and the size,alpha-fetoprotein(AFP)level and pathological differentiation level of hepatocellular carcinoma in patients with hepatitis B cirrhosis.Methods The clinical and imaging data of 103 patients with hepatitis B cirrhosis complicated with liver cancer were retrospectively analyzed.They were assinged to capsule group and non-capsule group according to the characteristics of plain and enhanced magnetic resonance imaging(MRI).The tumor diameter,alpha fetoprotein(AFP)level and pathological differentiation were compared between the two groups.Results A total of 79 small hepatocellular carcinomas were detected,of which 14 were highly differentiated and 65 were moderately differentiated.There were 32 small hepatocellular carcinomas with pseudocapsule sign,involving 18 cases with intact capsules and 14 with incomplete capsules.There were 47 small hepatocellular carcinomas without capsules.The tumor diameter in the capsule group was significantly larger than that in non-capsule group(1.85[1.50,2.30]cm vs 1.50[1.10,1.90]cm,z=2.53,P=0.001).There was no significant difference in the overall distribution of AFP level and pathological differentiation between groups(P>0.05).Conclusion The pseudocapsule sign of liver cancer is highly prevalent in the portal phase and equilibrium phase of enhanced MRI.Tumor size of lung cancer is correlated with the pseudocapsule sign.

关 键 词：乙肝肝硬化 HCC 磁共振成像 包膜 AFP 

分 类 号：R735.7[医药卫生—肿瘤]