演題

IS-3-7

Preoperative prediction of microvascular invasion in patients with hepatocellular carcinoma

[演者] Tsung-Han Wu:1
[著者] Etsuro Hatano:2, Kenya Yamanaka:2, Satoru Seo:2, Kojiro Taura:2, Yasuhiro Fujimoto:2, Masaki Mizumoto:2, Akira Mori:2, Hideaki Okajima:2, Toshimi Kaido:2, Shinji Uemoto:2
1:Dept Surgery, Chang-Gung Memorial Hospital, Chang-Gung University, 2:Dept Surgery, Graduate School of Medicine, Kyoto University

Backgound:Microvascular invasion (mVI) is known to be the risk factor of hepatocellular carcinoma (HCC) recurrence and affects treatment option. Several factors such as tumor grade, size, tumor margin status on image study, fluorine-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) result, and tumor markers have been proposed to predict mVI of HCC. However, the values of these factors have not been validated.Methods:Among patients receiving CT/MRI, FDG-PET, and tumor markers prior to the hepatectomy / liver transplantation from 2007 to 2012, 64 HCC patients diagnosed as no apparent of macrovascular invasion in pre-operative image were enrolled in this study. The image tumor margin status (smooth/non-smooth), FDG-PET result, tumor markers (PIVKA-2 & AFP) as previously described as predicting factors for mVI were evaluated.Result:Twelve patients had mVI (mVI+ group) and 52 patients had no evidence of mVI (mVI- group) on pathological examination. The mVI+ group had higher standardized uptake value (SUV) and tumor-to-nontumor SUV ratio (TNR) of FDG-PET than those of mVI- group. (5.51 vs. 3.85; p=0.03; 1.88 vs. 1.36; p=0.03). The mVI+ group also had higher rate of non-smooth tumor margin in imaging study. (83% vs. 21%; p<0.0001). No significant differences of tumor size and tumor marker were observed between two groups. Multi-variate analysis demonstrated only non-smooth tumor margin was identified as the significant predicting factor of mVI. (Odds ratio: 20.80, p=0.0002)Conclusion:Tumor margin status on preoperative imaging study is useful to predict HCC mVI. Therefore, we need prospective study to confirm these findings.
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