肝细胞癌的三维MR弹性成像作为预测肿瘤复发的潜在生物标志

StephenW

J Magn Reson Imaging. 2018 Sep 8. doi: 10.1002/jmri.26250. [Epub ahead of print]
3D MR Elastography of Hepatocellular Carcinomas as a Potential Biomarker for Predicting Tumor Recurrence.
Wang J1, Shan Q1, Liu Y2, Yang H1, Kuang S1, He B1, Zhang Y1, Chen J1, Zhang T1, Glaser KJ3, Zhu C4, Chen J3, Yin M3, Venkatesh SK3, Ehman RL3.
Author information

1
    Department of Radiology, Sun Yat-Sen University (SYSU), Guangzhou, Guangdong, P.R. China.
2
    Department of Pathology, Third Affiliated Hospital, Sun Yat-Sen University (SYSU), Guangzhou, Guangdong, P.R. China.
3
    Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
4
    Department of Epidemiology and Biostatistics, West China School of Public Health Sichuan University, Chengdu, P.R. China.

Abstract
BACKGROUND:

Preoperative prediction of tumor recurrence is important in the management of patients with hepatocellular carcinoma (HCC).
PURPOSE:

To investigate whether tumor stiffness derived by magnetic resonance elastography (MRE) could predict early recurrence of HCC after hepatic resection.
STUDY TYPE:

Retrospective.
POPULATION:

In all, 99 patients with pathologically confirmed HCCs after surgical resection.
FIELD STRENGTH/SEQUENCE:

3.0T; preoperative MRE with 60-Hz mechanical vibrations using an active acoustic driver.
ASSESSMENT:

Regions of interest (ROIs) were manually drawn in the tumors to measure mean tumor stiffness. Surgical specimens were reviewed for histological grade, capsule, vascular invasion, and surgical margins. The early recurrence of HCC was defined as that occurring within 2 years after resection.
STATISTICAL TESTS:

Cox proportional hazard models were used to evaluate risk factors associated with the time to early recurrence.
RESULTS:

HCCs with recurrence had higher tumor stiffness, higher rate of advanced T stage, vascular invasion, lower rate of capsule formation, larger tumor size, higher aspartate aminotransferase (AST), and hepatitis B virus (HBV)-DNA level and aspartate aminotransferase / alanine aminotransferase ratio (P = 0.031, 0.007, 0.01, <0.001, 0.015, 0.034, 0.01, and 0.014, respectively) than HCCs without recurrence. Vascular invasion (hazard ratio [HR] = 2.922; 95% confidence interval [CI]: [1.079, 7.914], P = 0.035) and mean tumor stiffness (HR = 1.163; 95% CI: [1.055, 1.282], P = 0.002) were risk factors associated with early recurrence. Each 1-kPa increase in tumor stiffness was associated with a 16.3% increase in the risk for tumor recurrence.
DATA CONCLUSION:

The mean stiffness of HCCs may be a useful, noninvasive, quantitative biomarker for the prediction of early HCC recurrence after hepatic resection.
LEVEL OF EVIDENCE:

4 Technical Efficacy: Stage 5 J. MAGN. RESON. IMAGING 2018.

© 2018 International Society for Magnetic Resonance in Medicine.
KEYWORDS:

hepatocellular carcinoma; histological grade; recurrence; tumor capsule; tumor stiffness

PMID:
    30260529
DOI:
    10.1002/jmri.26250

StephenW

J Magn Reson Imaging。 2018年9月8日doi：10.1002 / jmri.26250。 [提前打印]
肝细胞癌的三维MR弹性成像作为预测肿瘤复发的潜在生物标志物。
Wang J1，Shan Q1，Liu Y2，Yang H1，Kuang S1，He B1，Zhang Y1，Chen J1，Zhang T1，Glaser KJ3，Zhu C4，Chen J3，Yin M3，Venkatesh SK3，Ehman RL3。
作者信息

1
    中山大学放射学系，广东广州，中国。
2
    中山大学附属第三医院病理科，广东广州，中国。
3
    美国明尼苏达州罗切斯特市梅奥诊所梅奥诊所医学院放射科。
4
    四川大学华西公共卫生学院流行病学与生物统计学系，成都，中国。

抽象
背景：

肿瘤复发的术前预测对于肝细胞癌（HCC）患者的管理非常重要。
目的：

调查磁共振弹性成像（MRE）导致的肿瘤僵硬度是否可以预测肝切除术后HCC的早期复发。
学习类型：

回顾。
人口：

总共有99例经手术切除后经病理证实的HCC患者。
场强/序列：

3.0T;术前MRE使用有源声学驱动器进行60 Hz机械振动。
评定：

在肿瘤中手动绘制感兴趣区域（ROI）以测量平均肿瘤硬度。检查手术标本的组织学分级，胶囊，血管侵犯和手术切缘。 HCC的早期复发定义为切除后2年内发生的复发。
统计测试：

Cox比例风险模型用于评估与早期复发时间相关的风险因素。
结果：

复发的HCC具有较高的肿瘤僵硬度，较高的T期，血管侵犯率，较低的囊形成率，较大的肿瘤大小，较高的天冬氨酸氨基转移酶（AST）和乙型肝炎病毒（HBV）-DNA水平和天冬氨酸氨基转移酶/丙氨酸氨基转移酶比率（分别为P = 0.031,0.007,0.01，<0.001,0.015,0.034,0.01和0.014）比没有复发的HCC。血管侵犯（风险比[HR] = 2.922; 95％置信区间[CI]：[1.079,7.914]，P = 0.035）和平均肿瘤僵硬度（HR = 1.163; 95％CI：[1.055,1.282]，P = 0.002）是与早期复发相关的风险因素。肿瘤僵硬度每增加1kPa，肿瘤复发风险增加16.3％。
数据结论：

HCC的平均硬度可能是一种有用的，非侵入性的定量生物标志物，用于预测肝切除术后早期HCC复发。
证据等级：

4技术功效：第5阶段J. MAGN。 RESON。成像2018年。

©2018国际医学磁共振学会。
关键词：

肝细胞癌;组织学分级;复发;肿瘤囊;肿瘤僵硬

结论：
    30260529
DOI：
    10.1002 / jmri.26250