Hepatocellular Carcinoma with β-Catenin Mutation: Imaging and Pathologic Characteristics
Hepatocellular Carcinoma with β-Catenin Mutation: Imaging and Pathologic Characteristics
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DOI：
10.1148/radiol.14141315
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发表时间：
2015-06-01
期刊：
影响因子：
19.7
通讯作者：
Gabata, Toshifumi
中科院分区：
文献类型：
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作者：
Kitao, Azusa;Matsui, Osamu;Gabata, Toshifumi
目的：为了明确肝细胞癌（HCC）与β-catenin突变相关的影像学特征及其与病理结果的关系，材料和方法：获得伦理委员会批准和知情同意。本研究分析了138例手术切除的HCC。将β-catenin及其转录产物谷氨酰胺合成酶（GS）的免疫组化表达分级并分为3组：β-catenin阳性GS阳性组（HCC伴β-catenin突变）、β-catenin阴性GS阳性组（HCC中度）和β-catenin阴性GS阴性组（HCC无β-catenin突变）。评价动态计算机断层扫描（CT）和钆塞酸增强磁共振（MR）成像（T1加权、T2加权、弥散加权和肝胆期成像）的临床、病理和影像学表现。评价β-连环蛋白、GS和有机阴离子转运多肽1B 3（钆塞酸摄取转运蛋白）免疫组化表达之间的相关性。结果：在弥散加权成像中，β-连环蛋白突变的肝癌（n = 27）的中位对比噪声比低于中度肝癌（n = 23）和无β-连环蛋白突变的肝癌（n = 84）（分别为13.2、24.4和27.0; P = 0.02），表观扩散系数较高（分别为1.33、1.13和1.12; P < .0001），对比噪声比更高（分别为0.58、-28.7和-45.0; P < .0001）和肝胆期较高的增强比（分别为0.90、0.50和0.42; P < .0001）。在病理学检查中，β-连环蛋白突变的HCC表现出假腺体增生和胆汁生成，分化程度更高（分别为P = 0.04、0.001和0.005）。β-catenin、GS和有机阴离子转运多肽1B 3的表达呈显著正相关（P < .0001）。具有β-连环蛋白突变的HCC表现出更高的分化程度，具有频繁的假腺体模式和胆汁产生，特征性的影像学表现包括钆塞酸增强MR成像的高增强比和扩散时的高表观扩散系数，加权成像（C）RSNA，2015年
Purpose: To identify the imaging features of hepatocellular carcinoma (HCC) associated with beta-catenin mutation and their relationship to pathologic findings.Materials and Methods: Institutional ethics committee approval and informed consent were obtained. One hundred thirty-eight surgically resected HCCs were analyzed in this study. Immunohistochemical expression of beta-catenin and its transcriptional product, glutamine synthetase (GS), were graded and classified into three groups: the beta-catenin positive and GS positive group (HCC with beta-catenin mutation), the beta-catenin negative and GS positive group (intermediate HCC), and the beta-catenin negative and GS negative group (HCC without beta-catenin mutation). Clinical, pathologic, and imaging findings from dynamic computed tomography (CT) and gadoxetic acid-enhanced magnetic resonance (MR) imaging (T1-weighted, T2-weighted, diffusion-weighted, and hepatobiliary phase imaging) were evaluated. Correlations among immunohistochemical expression of beta-catenin, GS, and organic anion transporting polypeptide 1B3 (uptake transporter of gadoxetic acid) were evaluated. The x(2), Kruskal-Wallis, and Spearman correlation tests were used.Results: HCCs with beta-catenin mutation (n = 27) showed a lower median contrast-to-noise ratio at diffusion-weighted imaging than did intermediate HCCs (n = 23) and HCCs without beta-catenin mutation (n = 84) (13.2, 24.4, and 27.0, respectively; P = .02), higher apparent diffusion coefficient (1.33, 1.13, and 1.12, respectively; P < .0001), higher contrast-to-noise ratio (0.58, -28.7, and -45.0, respectively; P < .0001) and higher enhancement ratio during the hepatobiliary phase (0.90, 0.50, and 0.42, respectively; P < .0001). At pathologic examination, HCCs with beta-catenin mutation showed pseudoglandular proliferation and bile production with a higher grade of differentiation (P = .04, .001, and .005, respectively). There were significant positive correlations among expression of beta-catenin, GS, and organic anion transporting polypeptide 1B3 (P < .0001).Conclusion: HCCs with beta-catenin mutation showed a higher grade of differentiation with frequent pseudoglandular patterns and bile production, and characteristic imaging findings included a high enhancement ratio at gadoxetic acid-enhanced MR imaging and a high apparent diffusion coefficient at diffusion-weighted imaging. (C)RSNA, 2015