肝癌微血管侵犯的增强CT评估及风险因素分析

目的探讨肝癌微血管侵犯的增强CT评估价值及风险因素。方法选取89例原发性肝癌患者(术后病理确诊),根据病理结果显示是否存在微血管浸润分为2组。研究组为微血管浸润(50例),而对照组为非微血管浸润(39例),比较2组患者的病理学指标及CT征象差异。结果2组患者的病理学指标比较,差异均有统计学意义(P<0.05)。除弥散系数外,2组患者的其余CT征象比较均有统计学意义(P<0.05)。多因素分析显示肿瘤大小、包膜类型及边缘情况均是影响肝癌发生微血管侵犯的独立危险因素(P<0.05)。结论原发性肝癌合并微血管浸润患者的病理学及影像学征象具有一定的特点,其中肿瘤大小、包膜类型及边缘情况均是影响肝癌发生微血管侵犯的独立危险因素,此对原发性肝癌合并微血管浸润患者的诊疗具有较为深远的临床意义。

Enhanced CT Evaluation of Microvascular Invasion in Hepatocellular Carcinoma andAnalysis of Its Risk Factors

Objective To investigate the enhanced CT assessment value and risk factors of microvascular invasion in hepatocellular carcinoma.Methods 89 patients with primary hepatocellular carcinoma(pathologically confirmed after surgery)were selected and divided into 2 groups according to whether pathological findings showed the presence of microvascular infiltration.The study group was microvascular infiltration(50 patients),while the control group was non-microvascular infiltration(39 patients),and the differences in pathological indices and CT signs between the 2 groups were compared.Results The differences in pathological indices between the 2 groups were statistically significant(P<0.05).Except for the diffusion coefficient,the remaining CT signs of the patients in the 2 groups were statistically significant(P<0.05).Multiple factors showed that tumor size,envelope type and margin condition were all independent risk factors for microvascular invasion in hepatocellular carcinoma(P<0.05).Conclusion The pathological and imaging signs of primary hepatocellular carcinoma combined with microvascular infiltration have certain characteristics,and tumor size,envelope type and margin are independent risk factors for microvascular invasion of hepatocellular carcinoma,which has far-reaching clinical significance for the treatment of primary hepatocellular carcinoma combined with microvascular infiltration.