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Abstract：
BACKGROUND: Hepatocellular carcinoma (HCC) is one of the deadliest malignant tumors in China. Microvascular invasion (MVI) often indicates poor prognosis and metastasis in HCC patients. 18F-FDG PET-CT is a new imaging method commonly used to screen for tumor occurrence and evaluate tumor stage.
OBJECTIVE: This study attempted to predict the occurrence of MVI in early-stage HCC through 18F-FDG positron emission tomography (PET)/computed tomography (CT) imaging findings and laboratory data.
METHODS: A total of 113 patients who met the inclusion criteria were divided into two groups based on postoperative pathology: the MVI-positive group and MVI-negative group. We retrospectively analyzed the imaging findings and laboratory data of 113 patients. Imaging findings included tumor size, tumor maximum standard uptake value (SUVmaxT), and normal liver maximum standard uptake value (SUVmaxL). The ratios of SUVmaxT to SUVmaxL (SUVmaxT/L) and an SUVmaxT/L > 2 were defined as active tumor metabolism. The tumor size was indicated by the maximum diameter of the tumor, and a diameter greater than 5 cm was defined as a mass lesion. The laboratory data included the alpha-fetoprotein (AFP) level and the HBeAg level. An AFP concentration > 20 ng/mL was defined as a high AFP level. A HBeAg concentration > 0.03 NCU/mL was defined as HB-positive.
RESULTS: The SUVmaxT/L (p = 0.003), AFP level (p = 0.008) and tumor size (p = 0.015) were significantly different between the two groups. Patients with active tumor metabolism, mass lesions and high AFP levels tended to be MVI positive. Binary logistic regression analysis verified that active tumor metabolism (OR = 4.124, 95% CI, 1.566-10.861; p = 0.004) and high AFP levels (OR = 2.702, 95% CI, 1.214-6.021; p = 0.015) were independent risk factors for MVI. The sensitivity of the combination of these two independent risk factors predicting HCC with MVI was 56.9% (29/51), the specificity was 83.9% (52/62) and the accuracy was 71.7% (81/113).
CONCLUSIONS: Active tumor metabolism and high AFP levels can predict the occurrence of MVI in HCC patients.
OBJECTIVE: This study attempted to predict the occurrence of MVI in early-stage HCC through 18F-FDG positron emission tomography (PET)/computed tomography (CT) imaging findings and laboratory data.
METHODS: A total of 113 patients who met the inclusion criteria were divided into two groups based on postoperative pathology: the MVI-positive group and MVI-negative group. We retrospectively analyzed the imaging findings and laboratory data of 113 patients. Imaging findings included tumor size, tumor maximum standard uptake value (SUVmaxT), and normal liver maximum standard uptake value (SUVmaxL). The ratios of SUVmaxT to SUVmaxL (SUVmaxT/L) and an SUVmaxT/L > 2 were defined as active tumor metabolism. The tumor size was indicated by the maximum diameter of the tumor, and a diameter greater than 5 cm was defined as a mass lesion. The laboratory data included the alpha-fetoprotein (AFP) level and the HBeAg level. An AFP concentration > 20 ng/mL was defined as a high AFP level. A HBeAg concentration > 0.03 NCU/mL was defined as HB-positive.
RESULTS: The SUVmaxT/L (p = 0.003), AFP level (p = 0.008) and tumor size (p = 0.015) were significantly different between the two groups. Patients with active tumor metabolism, mass lesions and high AFP levels tended to be MVI positive. Binary logistic regression analysis verified that active tumor metabolism (OR = 4.124, 95% CI, 1.566-10.861; p = 0.004) and high AFP levels (OR = 2.702, 95% CI, 1.214-6.021; p = 0.015) were independent risk factors for MVI. The sensitivity of the combination of these two independent risk factors predicting HCC with MVI was 56.9% (29/51), the specificity was 83.9% (52/62) and the accuracy was 71.7% (81/113).
CONCLUSIONS: Active tumor metabolism and high AFP levels can predict the occurrence of MVI in HCC patients.
摘要：
背景：肝细胞癌（HCC）是中国最致命的恶性肿瘤之一。微血管侵犯（MVI）通常表明HCC患者预后不良和转移。18F-FDGPET-CT是一种常用于筛查肿瘤发生和评估肿瘤分期的新成像方法。
目的：本研究试图通过18F-FDG正电子发射断层扫描（PET）/计算机断层扫描（CT）成像结果和实验室数据来预测早期HCC中MVI的发生。
方法：将符合纳入标准的113例患者根据术后病理分为两组：MVI阳性组和MVI阴性组。我们回顾性分析了113例患者的影像学表现和实验室数据。影像学检查结果包括肿瘤大小，肿瘤最大标准摄取值（SUVmaxT），和正常肝脏最大标准摄取值（SUVmaxL）。SUVmaxT与SUVmaxL的比率(SUVmaxT/L)和SUVmaxT/L>2被定义为活跃的肿瘤代谢。肿瘤的最大直径表示肿瘤的大小，直径大于5cm被定义为肿块。实验室数据包括甲胎蛋白（AFP）水平和HBeAg水平。AFP浓度>20ng/mL被定义为高AFP水平。HBeAg浓度>0.03NCU/mL被定义为HB阳性。
结果：SUVmaxT/L（p=0.003），两组之间的AFP水平（p=0.008）和肿瘤大小（p=0.015）显着差异。肿瘤代谢活跃的患者，肿块和高AFP水平倾向于MVI阳性。二元logistic回归分析证实，肿瘤代谢活跃（OR=4.124，95%CI，1.566-10.861；p=0.004）和高AFP水平（OR=2.702，95%CI，1.214-6.021；p=0.015）是MVI的独立危险因素。这两个独立危险因素联合预测HCC合并MVI的敏感性为56.9%(29/51),特异性为83.9%(52/62),准确性为71.7%(81/113).
结论：活跃的肿瘤代谢和高AFP水平可以预测HCC患者MVI的发生。
目的：本研究试图通过18F-FDG正电子发射断层扫描（PET）/计算机断层扫描（CT）成像结果和实验室数据来预测早期HCC中MVI的发生。
方法：将符合纳入标准的113例患者根据术后病理分为两组：MVI阳性组和MVI阴性组。我们回顾性分析了113例患者的影像学表现和实验室数据。影像学检查结果包括肿瘤大小，肿瘤最大标准摄取值（SUVmaxT），和正常肝脏最大标准摄取值（SUVmaxL）。SUVmaxT与SUVmaxL的比率(SUVmaxT/L)和SUVmaxT/L>2被定义为活跃的肿瘤代谢。肿瘤的最大直径表示肿瘤的大小，直径大于5cm被定义为肿块。实验室数据包括甲胎蛋白（AFP）水平和HBeAg水平。AFP浓度>20ng/mL被定义为高AFP水平。HBeAg浓度>0.03NCU/mL被定义为HB阳性。
结果：SUVmaxT/L（p=0.003），两组之间的AFP水平（p=0.008）和肿瘤大小（p=0.015）显着差异。肿瘤代谢活跃的患者，肿块和高AFP水平倾向于MVI阳性。二元logistic回归分析证实，肿瘤代谢活跃（OR=4.124，95%CI，1.566-10.861；p=0.004）和高AFP水平（OR=2.702，95%CI，1.214-6.021；p=0.015）是MVI的独立危险因素。这两个独立危险因素联合预测HCC合并MVI的敏感性为56.9%(29/51),特异性为83.9%(52/62),准确性为71.7%(81/113).
结论：活跃的肿瘤代谢和高AFP水平可以预测HCC患者MVI的发生。
