Arterial blood supply of hepatocellular carcinoma and histologic grading: Radiologic-pathologic correlation
Arterial blood supply of hepatocellular carcinoma and histologic grading: Radiologic-pathologic correlation
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DOI：
10.2214/ajr.07.2117
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发表时间：
2008-01-01
影响因子：
5
通讯作者：
Honda, Hiroshi
中科院分区：
文献类型：
--
作者：
Asayama, Yoshiki;Yoshimitsu, Kengo;Honda, Hiroshi
OBJECTIVE.本研究的目的是阐明肝细胞癌（HCC）发展过程中动脉血供的顺序性变化，重点是晚期HCC。在59例接受CT肝动脉造影和CT动脉门静脉造影（CTAP）的患者中，病理证实了60个HCC结节。病变分为四组：第1组，CTAP显示门脉灌注保留，CT肝动脉造影显示低或等密度的结节;第2组，CT肝动脉造影显示极高密度;第3组，CT肝动脉造影显示高密度;第4组，CT肝动脉造影显示低或等密度。第2、3和4组在CTAP上显示门脉灌注缺损。这些血流动力学模式之间进行了比较不同的组织学分级。我们还检查了不成对的动脉的数量和Ki-67标记指数的肿瘤病理学。各组中的病变数量分别如下：第1、2、3和4组分别为17、1、2和0例高分化HCC; 0、10、9和1例中度分化HCC; 0、3、12和5例低分化HCC。不同组织学分级的病变显示出显著不同的血流动力学模式（Cramer's V = 0.6919，p < 0.0001）。高分化和中分化HCC中未配对动脉数与Ki-67标记指数呈强相关（rho = 0.673，p < 0.0001），低分化HCC中未配对动脉数与Ki-67标记指数呈中度负相关（rho =-0.540，p = 0.0185）。在HCC发展的晚期，动脉血供随着组织学分级的进展而显著减少。
OBJECTIVE. The objective of our study was to clarify the sequential changes of arterial blood supply during the development of hepatocellular carcinoma (HCC) with an emphasis on its late stage.MATERIALS AND METHODS. Sixty HCC nodules were confirmed at pathology in 59 patients who had undergone CT hepatic arteriography and CT during arterioportography (CTAP). Lesions were classified into one of the four groups: group 1, nodules that appeared to show preserved portal perfusion on CTAP and showed hypo- or isoattenuation on CT hepatic arteriography; group 2, very hyperattenuating on CT hepatic arteriography; group 3, hyperattenuating on CT hepatic arteriography; and group 4, hypo- or isoattenuating on CT hepatic arteriography. Groups 2, 3, and 4 showed the portal perfusion defect on CTAP. These hemodynamic patterns were compared among different histologic grades. We also examined the number of unpaired arteries and the Ki-67 labeling index of the tumor pathologically.RESULTS. The numbers of lesions in each group were as follows for groups 1, 2, 3, and 4, respectively: 17, one, two, and 0 well-differentiated HCCs; 0, 10, nine, and one moderately differentiated HCC; and 0, three, 12, and five poorly differentiated HCCs. The lesions showed significantly different hemodynamic patterns among different histologic grades (Cramer's V = 0.6919, p < 0.0001). The number of unpaired arteries showed a strong correlation with Ki-67 labeling index in well-differentiated HCC and moderately differentiated HCC (rho = 0.673, p < 0.0001) and a moderate inverse correlation with Ki-67 labeling index in poorly differentiated HCC (rho = - 0.540, p = 0.0185).CONCLUSION. In the late stage of HCC development, the arterial blood supply significantly decreases as the histologic grade progresses.