Prognostic Significance of Concurrent Hypovascular and Hypervascular Nodules in Patients with Hepatocellular Carcinoma.
Prognostic Significance of Concurrent Hypovascular and Hypervascular Nodules in Patients with Hepatocellular Carcinoma.
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DOI：
10.1371/journal.pone.0163119
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Yokosuka O
中科院分区：
文献类型：
--
作者：
Ogasawara S;Chiba T;Motoyama T;Kanogawa N;Saito T;Shinozaki Y;Suzuki E;Ooka Y;Tawada A;Kato H;Okabe S;Kanai F;Yoshikawa M;Yokosuka O
低血管结节常与高血管性肝细胞癌（HCC）同时发生。然而，与高血管性HCC相关的低血管结节是否有任何预后价值仍存在争议。本研究通过动脉门静脉造影（CTAP）和肝动脉造影（CTHA）期间的计算机断层扫描（ct）诊断低血管性结节合并高血管性HCC，评估其对预后的影响，CTHA可以灵敏地捕捉早期HCC患者门静脉和肝动脉血流的动态变化。回顾性分析152例初始行局部消融治疗的高血管性HCC（≤30 mm，≤3个结节）患者。所有患者在治疗前均接受CTAP和CTHA治疗。比较A组（仅高血管性HCC， 107例）和B组（低血管性结节和高血管性HCC， 45例）的总生存期（OS）。在所有低血管结节中，81%（57例中的46例）在随访期间发展为血管增生。1年和2年的血管增生率分别为17%和51%。A组的OS明显长于B组（P < 0.001）。Cox比例风险模型确定低血管结节并发高血管HCC是一个独立的不良预后因素。在CTAP和CTHA中发现低血管结节的高血管HCC患者预后较差。有和没有低血管性结节的患者的临床HCC类型似乎不同。
Hypovascular nodules often occur together with hypervascular hepatocellular carcinoma (HCC). However, it remains controversial whether hypovascular nodules associated with hypervascular HCC have any prognostic value. This study evaluated the prognostic impact of hypovascular nodules co-existing with hypervascular HCC as diagnosed by computed tomography during arterial portography (CTAP) and computed tomography during hepatic arteriography (CTHA), which can sensitively capture the dynamic changes in blood flow through the portal vein and hepatic artery in patients with early stage HCC. A total of 152 patients with hypervascular HCC (≤ 30 mm, ≤ 3 nodules), who underwent initial local ablation, were analyzed retrospectively. All patients received CTAP and CTHA prior to treatment. Overall survival (OS) was compared among group A (hypervascular HCC only, 107 patients) and group B (hypovascular nodules and hypervascular HCC, 45 patients). Among all hypovascular nodules, 81% (46 of 57) developed hypervascularization within the follow-up period. The 1- and 2-year hypervascularization rates were 17% and 51%, respectively. OS was significantly longer for group A than for group B (P < 0.001). A Cox proportional-hazards model identified the presence of hypovascular nodules concurrent with hypervascular HCC as an independent poor prognostic factor. The prognosis of hypervascular HCC patients with hypovascular nodules detected during CTAP and CTHA is poor. Clinical HCC categories seem to be dissimilar between patients with and without hypovascular nodules.
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影响因子：
2.3
作者：
Inoue, Tatsuo;Hyodo, Tomoko;Kudo, Masatoshi
通讯作者：
Kudo, Masatoshi
影响因子：
25.7
作者：
Toyoda, Hidenori;Kumada, Takashi;Maeda, Atsuyuki
通讯作者：
Maeda, Atsuyuki
影响因子：
3.7
作者：
Ogasawara S;Chiba T;Ooka Y;Kanogawa N;Motoyama T;Suzuki E;Tawada A;Azemoto R;Shinozaki M;Yoshikawa M;Yokosuka O
通讯作者：
Yokosuka O
影响因子：
8.4
作者：
通讯作者：
--
影响因子：
6.2
作者：
Kobayashi, M;Ikeda, K;Kumada, H
通讯作者：
Kumada, H