CAJ | 학술논문

目的：探讨肝细胞癌(hepatocellular carcinoma,HCC)肝内早期复发转移的治疗前增强 CT 表现影响因素。方法回顾性收集2003-07-2009-01在本院收治的115例 HCC 患者的临床及治疗前多期增强 CT 资料,所有病例均有规律影像学随访结果。测量记录 CT 征象及其肝内复发转移情况,经单因素方差分析、卡方检验,对影响 HCC 早期复发转移的 CT 表现因素进行初筛。将有统计学意义的指标行 Logistic 回归多因素分析,以 P <0.05为有统计学意义。结果本组 HCC 患者肝内早期复发转移率为58.26%。经单因素分析显示 HCC 病灶大小、部位、范围、包膜、子灶、血管侵犯、动静脉瘘、坏死对 HCC 肝内早期复发转移有影响(P <0.05)。Logistic 回归多因素分析结果表明病灶大小、子灶、血管侵犯、包膜是影响 HCC 早期复发的独立因素(P =0.031,0.005、0.037、0.048)。结论 CT 表现同 HCC 肝内早期复发转移密切相关,肿瘤较大、伴有子灶、无完整包膜和伴有血管侵犯提示患者易于早期复发转移。
목적：탐토간세포암(hepatocellular carcinoma,HCC)간내조기복발전이적치료전증강 CT 표현영향인소。방법회고성수집2003-07-2009-01재본원수치적115례 HCC 환자적림상급치료전다기증강 CT 자료,소유병례균유규률영상학수방결과。측량기록 CT 정상급기간내복발전이정황,경단인소방차분석、잡방검험,대영향 HCC 조기복발전이적 CT 표현인소진행초사。장유통계학의의적지표행 Logistic 회귀다인소분석,이 P <0.05위유통계학의의。결과본조 HCC 환자간내조기복발전이솔위58.26%。경단인소분석현시 HCC 병조대소、부위、범위、포막、자조、혈관침범、동정맥루、배사대 HCC 간내조기복발전이유영향(P <0.05)。Logistic 회귀다인소분석결과표명병조대소、자조、혈관침범、포막시영향 HCC 조기복발적독립인소(P =0.031,0.005、0.037、0.048)。결론 CT 표현동 HCC 간내조기복발전이밀절상관,종류교대、반유자조、무완정포막화반유혈관침범제시환자역우조기복발전이。
Objective To explore the risk factors for early interhepatic recurrence and metastasis of hepatocellular carcinoma (HCC)on CT imaging before treatment.Methods 1 1 5 patients suffered from HCC from July 2003 to January 2009 were retrospec-tively enrolled for reviewing their clinical characteristics and CT signs.The status of metastasis and/or recurrence was followed reg-ularly.Signs on pre-treatment enhanced CT images were measured and analyzed.Analysis of variance and independent sampler t test were applied for Univariate survival analysis.Then multivariate analysis was carried out by the Logistic regression,Lon rank meth-od,and p-value < 0.05 was defined to be statistically significant.Results The early interhepatic recurrence and metastasis rate of the study group was 58.26%.With univariate analysis,tumor size,location,extent,capsule,satellite nodule,vascular invasion, AVM and necrosis were the risk factors for early recurrence and metastasis of HCC on pre-treatment enhanced CT imaging (P<0.05).Multi-variable Logistic regression analysis showed that tumor size,satellite nodule,vascular invasion capsule and were independently sig-nificant CT signs for early interhepatic recurrence and metastasis of HCC (P =0.031,0.005、0.037、0.048).Conclusion Pre-treat-ment enhanced CT imaging with HCC was closely related to early interhepatic recurrence and metastasis of the tumor.A tumor of larger size,with satellite nodules,without complete capsule and vascular invasion on CT may predict a tendency to early interhepatic recurrence and metastasis of HCC.