中华肝脏病杂志最新文献

{"title":"[Comparative therapeutic efficacy of tenofovir amibufenamide versus tenofovir alafenamide in the treatment of patients with chronic hepatitis B: a real-world single- center study].","authors":"R Y Chen, X Y Lyu, S Huang, W Z Li, Z Z Zhai, Y H Wang, Y J Pan, Q L Zeng","doi":"10.3760/cma.j.cn501113-20240319-00142","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240319-00142","url":null,"abstract":"<p><p><b>Objective:</b> To compare the real-world efficacy and safety profile of tenofovir amibufenamid (TMF) and tenofovir alafenamide (TAF) tablets in the treatment of patients with chronic hepatitis B (CHB). <b>Methods:</b> This retrospective study included patients with chronic hepatitis B who received TMF and TAF antiviral treatment at the Infectious Disease Outpatient Department of the First Affiliated Hospital of Zhengzhou University from January 2021 to December 2023. The primary and secondary outcome was to study the patient HBV DNA conversion rate (<20 IU/ml), alanine aminotransferase (ALT) normalization rate, renal function, and lipid levels of patients at 48 weeks of treatment. The comparison of data between measurement data groups was differentiated using a <i>t</i>-test and Mann-Whitney <i>U</i> test. The inter-group comparison rate in count data was performed using the <i>χ</i>² test or Fisher's exact probability. <b>Results:</b> A total of 440 cases were enrolled, including 220 in the TMF group (63 treatment-naïve and 157 treatment-experienced) and 220 cases in the TAF group (61 treatment-naïve and 159 treatment-experienced). In terms of efficacy, the HBV DNA seroconversion rates in the TMF group and TAF group were 90.5% and 85.2% (<i>P</i>=0.372), respectively, while the ALT normalization rates were 92.1% and 88.5% (<i>P</i>=0.505), respectively, at 48 weeks of treatment. The HBV DNA-negative conversion rate for the newly treated patients was 99.4% and 98.7%, respectively (<i>P</i>=1.000), while the rates of ALT normalization were 94.9% and 92.3%, respectively (<i>P</i>=0.863). In terms of safety profile, the serum creatinine level was lower in the TMF group than that in the TAF group at 48 weeks of treatment [TMF group 66.5 (56.3, 78.3) μmol/L, TAF group 70.6 (60.7, 77.8) μmol/L, <i>Z</i>=-2.282, <i>P</i>=0.022]. However, there was no statistically significant difference in other renal function and tubular function related indicators between the two groups of patients (<i>P</i>>0.05). The serum high-density lipoprotein levels were higher in the TMF group than those in the TAF group [TMF 1.4 (1.1, 1.6) mmol/L vs. TAF group 1.3 (1.1, 1.6) mmol/L, <i>Z</i>=-2.204, <i>P</i>=0.027] at 48 weeks of treatment. However, there was no statistically significant difference in other blood lipid indicators between the two groups of patients (<i>P</i>>0.05). <b>Conclusion:</b> There is no statistically significant difference in efficacy and safety profiles between TMF and TAF at 48 weeks in the treatment of patients with chronic hepatitis B, and the overall safety profile is favorable.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 11","pages":"976-983"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Exploring the reasons for liver cancer occurrence still after long-term nucleos(t)ide analogue therapy in patients with chronic hepatitis B].","authors":"X Liu, X Y Du, F M Lu","doi":"10.3760/cma.j.cn501113-20231205-00266","DOIUrl":"10.3760/cma.j.cn501113-20231205-00266","url":null,"abstract":"<p><p>Chronic hepatitis B virus (HBV) infection is the main etiology of viral hepatitis, cirrhosis, and primary hepatocellular carcinoma and is also a major public health problem worldwide. With the progression of chronic infection, HBV DNA continuously integrates into host DNA and brings about integration and insertion mutations within host genes. In the process of repeated chronic inflammatory necrosis and compensatory regeneration, hepatocytes carrying HBV DNA integration have an advantage in proliferation and frequent clonal expansion formation that causes the accumulation of mutations over time and ultimately malignant transformation of hepatocytes. Although nucleos(t)ide analogs (NAs), currently the most widely used, can effectively inhibit viral replication, delay disease progression in patients with chronic hepatitis B, and significantly reduce the occurrence of end-stage liver disease, many patients still progress to liver cancer. Furthermore, even among clinically cured patients with hepatitis B surface antigen clearance, NAs have not significantly reduced the long-term occurrence of liver cancer, suggesting that their impact under previous treatment strategies for reducing the risk of liver cancer is limited. This could be due to antiviral treatment initiation at a time when patients already have numerous integrated cell proliferation colonies. Hence, NAs have not had any therapeutic impact on the expression of integrated HBV DNA fragments and viral proteins, such as hepatitis B surface antigen. In light of this, we suggest initiating antiviral treatment as early as possible to pursue clinical cure and ultimately reduce the risk of liver cancer in patients with chronic HBV infection.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 11","pages":"1032-1036"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[HBsAg trajectory and key watersheds towards functional cure of hepatitis B].","authors":"X E Liang, Z H Liu, Y Y Li, R Fan, J L Hou","doi":"10.3760/cma.j.cn501113-20240902-00466","DOIUrl":"10.3760/cma.j.cn501113-20240902-00466","url":null,"abstract":"<p><p>Chronic hepatitis B virus (HBV) infection remains a pivotal global public health concern. Attaining a functional cure for hepatitis B continues to be a hot and difficult issue that requires immediate attention in clinical practice. There are currently nucleos(t)ide analogues (NAs) that can persistently suppress HBV DNA; however, the functional cure rate of pegylated interferon alfa (PEG-IFN-α) alone or in combination with NAs has not yet met clinical needs. The research and development on novel mechanisms for HBV antiviral drugs, especially small nucleic acid drugs, has brought breakthroughs to the functional cure of hepatitis B. The functional cure trajectory mapping and its prediction model can guide the selection of clinical treatment strategies based on the longitudinal data for HBsAg at various time intervals. The personalized management of hepatitis B patients can be optimized by utilizing varying HBsAg levels as a key watershed to aid in the screening of subjects in clinical trials.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 ","pages":"961-964"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Interventional effect of bone marrow mesenchymal stem cell transplantation with different doses of X-ray irradiation induced hepatic injury in mice].","authors":"Y Liang, L Luo, T Y Cheng, G F Chen, W Liu, Y P Mu, J M Chen, P Liu","doi":"10.3760/cma.j.cn501113-20231122-00215","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20231122-00215","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the interventional effect of bone marrow mesenchymal stem cell (BMMSC) transplantation with different doses of X-ray irradiation induced hepatic injury in mice. &lt;b&gt;Methods:&lt;/b&gt; Eighteen female C57BL/6J mice were randomly divided into 0, 2, and 3 Gy irradiation groups and 0, 2, and 3 Gy transplantation groups. The irradiation group was used as the control and injected with an equal volume of culture medium. The mice in the transplantation group were irradiated with different doses of X-ray irradiation, and BMMSCs were intravenously infused into the bone marrow. The mice were sacrificed for sampling at the end of the 21st day. Mice body weight changes were recorded daily. The changes in the content of peripheral blood lymphocytes, red blood cells, platelets, and hemoglobin were detected by an automatic blood tester. The morphological changes in mice liver tissues were observed by hematoxylin-eosin staining. The serum activities of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected by a biochemical analyzer. The reduced glutathione contents in liver tissue were detected by the microplate method. The malondialdehyde content in liver tissue was detected by thiobarbituric acid. The content of total superoxide dismutase (T-SOD) in liver tissue was detected by the hydroxylamine method. The expression of the F4/80 protein in liver tissue was detected by the immunohistochemistry method. The protein expression of nuclear transcription factor erythroid 2 related factor 2 (Nrf2) and heme oxygenase 1 (HO-1) in liver tissue was determined by the western blotting method. The mRNA expression of NLRP3, IL-6, and Nrf2 in liver tissue was detected by a real-time quantitative polymerase chain reaction. The multiple-group comparisons were analyzed by factorial analysis of variance. The inter-group comparisons were analyzed by the LSD method for statistical analysis. &lt;b&gt;Results:&lt;/b&gt; The contents of peripheral blood lymphocytes, erythrocytes, platelets, and hemoglobin were significantly decreased in the 3 Gy irradiation group than the 0 Gy irradiation group (&lt;i&gt;P&lt;/i&gt;&lt;0.05), while the activities of serum ALT and AST were significantly increased (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The malondialdehyde content, F4/80 protein expression level, nucleotide-binding domain and leucine-rich repeats, nucleotide oligomerization domain-like receptor family, pyrin domain containing 3 (NLRP3), and interleukin 6 mRNA expression levels were significantly increased in liver tissue, while the contents of T-SOD and glutathione, Nrf2 and HO-1 protein expression levels, and Nrf2 mRNA expression level in liver tissue were significantly decreased (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The contents of peripheral blood lymphocytes, red blood cells, platelets, and hemoglobin were significantly increased in the 3 Gy transplantation group than the 3 Gy irradiation group (&lt;i&gt;P&lt;/i&gt;&lt;0.05), while the activities of serum ALT and AST were significantly decreased (&lt;i&gt;P&lt;/i&gt;&lt;0.0","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 11","pages":"1019-1027"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Genetic and clinical characteristics of 26 cases with glycogen storage disease type Ⅲ].","authors":"X Y Zhang, P Zhang, J Y Feng, X H Li, Y Lu, X B Xie, J S Wang","doi":"10.3760/cma.j.cn501113-20240719-00336","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240719-00336","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the genetic, clinical, and post-treatment characteristics of patients with glycogen storage disease type Ⅲ (GSD Ⅲ). <b>Methods:</b> A retrospective cohort analysis was performed on the genetic and clinical data of 26 cases with GSD Ⅲ who visited the Children's Hospital affiliated with Fudan University from June 2017 to December 2023. The patients were divided into non-missense variation and missense variation groups according to the types of mutation in the AGL gene.The correlation between genotype and phenotype was analyzed. All patients were treated with uncooked cornstarch after diagnosis. The changes before and after treatment were compared in patients who underwent more than twelve months of follow-up. A <i>P</i> value of <0.05 was used to denote statistical significance. <b>Results:</b> Among the 26 cases enrolled, 13 were female and 13 were male, and the median age of diagnosis was 28 (6 to 134) months. A total of thirty-five different types of <i>AGL</i> gene variation were detected, with c.1735+1G＞T (9/52, 17.3%) as the hotspot variation. The common clinical manifestations were elevated aminotransferases (26/26, 100%), hepatomegaly (25/26, 96.2%), fasting hypoglycemia (25/26, 96.2%), hyperketonemia (16/18, 88.9%), hypertriglyceridemia (TG) (20/26, 76.9%), elevated CK (16/25, 64.0%), and an abnormal electrocardiogram (12/16, 75.0%). Four cases (15.4%) had symptoms of myopathy at diagnosis. Liver biopsy was performed in eighteen cases, among whom 83.3% (15/18) had liver fibrosis≥S2. The number of cases with elevated levels of CK (<i>P</i>＝0.031) and ALT (<i>P</i>＝0.038)was pronounced in the non-missense variation group compared to that in the missense variation group. There were no statistically significant differences in age, height, liver size, degree of fibrosis, fasting blood glucose (Glu) and TG (<i>P</i>>0.05). The median follow-up time of 14 cases was 40.5 (20-73) months, with improvement in body stature, reduced liver size, decreased ALT and TG, and improved Glu. However, four (28.6%) cases had new myopathy symptoms with raised CK (<i>P</i><0.05) and with advancing age, increased ALT diminished while CK level elevated (<i>P</i><0.05). <b>Conclusions:</b> The common clinical manifestations at the early stage of the GSD Ⅲdiagnosis are elevated aminotransferases, hepatomegaly, fasting hypoglycemia, hyperketonemia, high triglycerides, elevated CK, and fibrotic liver in China. Myopathy symptoms may arise following uncooked cornstarch treatment; however, there is significant improvement in height, liver-related, and metabolic parameters.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 11","pages":"1005-1012"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Revealing research progress for immunological characteristics of chronic hepatitis B applying single-cell RNA sequencing technology].","authors":"C Shu, D Z Zhang","doi":"10.3760/cma.j.cn501113-20240426-00230","DOIUrl":"10.3760/cma.j.cn501113-20240426-00230","url":null,"abstract":"<p><p>Chronic hepatitis B (CHB) is one of the major public health problems worldwide. The potential immunological mechanisms of hepatitis B virus (HBV) infection has not yet been clearly studied. Single-cell RNA sequencing (scRNA-seq) technology, as an emerging sequencing method in recent years, can provide a high-throughput view of the whole transcriptome at the single-cell level, reveal subtle changes in transcriptional profiles of immune cells during the course of chronic hepatitis B, and provide technological support for exploring the immunopathogenesis and potential therapeutic targets for CHB. This article summarizes the research progress conducted on scRNA-seq technology in order to provide novel therapeutic ideas for the immunological characteristics of chronic hepatitis B.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 11","pages":"1042-1046"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Variational trend in disease characteristics of hepatitis B-related primary liver cancer populations in the past five years: a retrospective single-center cross-sectional study].","authors":"P P Jin, J Li, T F Liu, A D Ma, Y Y Liu, L Wang, G M Li, L Y Zhang","doi":"10.3760/cma.j.cn501113-20240326-00159","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240326-00159","url":null,"abstract":"<p><p><b>Objective:</b> To study the variational trend in disease characteristics of patients with hepatitis B-related primary liver cancer (HBV-HCC) in the past five years. <b>Method:</b> A single-center retrospective cross-sectional analysis was performed to compare patients diagnosed with HBV-HCC from January 2012 to December 2016 (control group) and from January 2017 to December 2021 (observation group). The data of the study variables were extracted from the electronic medical record system of the hospital information system of the Second Hospital of Lanzhou University. The 1:2 propensity score matching was used to adjust potential confounding factors such as gender and age. Multivariate logistic regression analysis was used to study the factors affecting changes in disease characteristics of the HBV-HCC population in the observation group. GraphPad Prism 8.0 software was used to draw forest plots to intuitively display the effect size of the study variables in the logistic regression analysis.The <i>t</i>-test was used to compare normally distributed data between groups. The <i>χ</i>² test was used for inter-group comparison. <b>Results:</b> A total of 1 717 eligible cases were collected, including 510 in the control group and 1 207 in the observation group. Compared with the control group, the number of newly diagnosed cases in the observation group increased by 2.36 times, and males were still the main onset population (83.3% vs. 82.7%). The median age of onset increased (51.9 vs. 53.5 years, <i>P</i><0.001). 79.4% of HBV-HCC patients had not received antiviral therapy, and the proportion of HBeAg-negative patients increased (56.4%). The factors affecting HBV-HCC patients included family history of HBV (<i>OR</i>=1.626, 95%<i>CI</i>: 1.181-2.238), family history of hepatocellular carcinoma (<i>OR</i>=1.388, 95%<i>CI</i>: 1.013-1.901), hypoviremia (<i>OR</i>=1.322, 95%<i>CI</i>: 1.046-1.671), abnormal alanine aminotransferase (<i>OR</i>=1.545, 95%<i>CI</i>: 1.231-1.940), liver fibrosis (<i>OR</i>=1.478, 95%<i>CI</i>: 1.153-1.894), liver cirrhosis (<i>OR</i>=1.431, 95%<i>CI</i>: 1.128-1.815), and metabolic-related fatty liver disease (<i>OR</i>=1.438, 95%<i>CI</i>: 1.116-1.815) after propensity score matching adjustment. The factors affecting HBeAg-positive patients were decreased (<i>OR</i>=0.390, 95%<i>CI</i>: 0.389-0.617); however, the number of early HBV-HCC diagnoses was increased (12.7% vs. 19.3%, <i>P</i>=0.001). <b>Conclusion:</b> The characteristics of patient disease and occurrence of HBV-HCC are changing over the past five years. The risk of developing hepatocellular carcinoma in middle- to older male patients with chronic hepatitis B is increasing with familial history of HBV and hepatocellular carcinoma, HBeAg negativity, hypoviremia, abnormal alanine aminotransferase, liver fibrosis, cirrhosis, and metabolic-related fatty liver disease.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 11","pages":"997-1004"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current status of treatment for acute variceal bleeding in liver cirrhosis].","authors":"Y Lyu, G H Han, D M Fan","doi":"10.3760/cma.j.cn501113-20240306-00113","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20240306-00113","url":null,"abstract":"<p><p>Acute variceal bleeding (AVB) continues to be a fatal complications of cirrhotic portal hypertension. Although the hospitalization rate of patients with acute variceal bleeding has significantly decreased with the advancement of medical technology, and the mortality rate has dropped from 50% three decades before to 15%～20% now, the in-hospital mortality rate is still high and is closely related to the severity of cirrhosis, ranging from 0 in Child A grade to 32% in Child C grade. Therefore, it is a good choice to risk stratify these patients and individualize the treatment method according to the expected risk, as the risk of death in patients with acute variceal bleeding is highly heterogeneous. This article mainly reviews the current status of risk stratification and treatment of acute variceal bleeding in cirrhosis.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 11","pages":"1037-1041"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Fluoxetine hydrochloride ameliorates symptoms of hepatic myelopathy: a case report].","authors":"J J Zhang, H R Gao","doi":"10.3760/cma.j.cn501113-20240131-00069","DOIUrl":"10.3760/cma.j.cn501113-20240131-00069","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 11","pages":"1028-1031"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Hepatobiliary phase image manifestation classification and pathological features of nodules in nodules accompanied by hepatocellular carcinoma].","authors":"F Xing, W J Zhu, J F Jiang, J Lu, T Zhang, Q R Ma","doi":"10.3760/cma.j.cn501113-20231221-00291","DOIUrl":"https://doi.org/10.3760/cma.j.cn501113-20231221-00291","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To analyze the hepatobiliary phase (HBP) image manifestation classification and pathological features of nodules in nodules accompanied by hepatocellular carcinoma (NIN-HCC). &lt;b&gt;Methods:&lt;/b&gt; Twenty-five cases cases (27 lesions) with cirrhosis who were confirmed as NIN-HCC by surgical pathology and underwent gadoxetate disodium-enhanced MRI examination before surgery at Nantong Third Hospital affiliated with Nantong University from July 2015 to November 2022 were retrospectively enrolled. The size, signal intensity, enhancement pattern, and pathological features of internal and external nodules were analyzed in NIN-HCC. The lesions score were recorded according to the 2018 version of the Liver Imaging Reporting and Data Systems (LI-RADS) classification criteria. NIN-HCCs were grouped and typed according to the different HBP signal intensities of the inner and outer nodules. The independent-samples &lt;i&gt;t&lt;/i&gt;-test, Mann-Whitney &lt;i&gt;U&lt;/i&gt; test or Fisher's exact probability method were used to compare the differences in imaging features and LI-RADS scores between the groups. The Spearman correlation coefficient was used to evaluate the correlation between the pathological differentiation degree of internal and external nodules and the HBP signal intensity. The Kaplan-Meier curve was used to analyze recurrence-free survival (RFS) following NIN-HCC surgery. &lt;b&gt;Results:&lt;/b&gt; The internal nodules of the 27 NIN-HCCs showed altered hypervascularity with a maximum diameter of (13.2±5.5) mm during the arterial phase. 51.9% (14/27) and 48.1% (13/27) showed \"fast in and fast out\" and fast in and slow out\"enhancement patterns. The external nodules showed altered hypovascularity with a maximum diameter of (25.7±7.3) mm, and 13 (48.1%) of them were accompanied to manifest during the arterial phase. NIN-HCC was divided into two groups according to the signal intensity of HBP of the outer nodules with the background liver parenchyma signal intensity as a reference: the hyposignal group (&lt;i&gt;n&lt;/i&gt;=17, 63.0%) and the isosignal group (&lt;i&gt;n&lt;/i&gt;=10, 37.0%). The hyposignal group and the isosignal group were divided into A~C type and D~F type, a total of six types, according to the hypo, iso, and hyper signals of the inner nodules and the signal intensity of the outer nodules as a reference. Within the hyposignal group, 7.4% (2/27) of the inner nodules showed hyposignal (type A), 37.0% (10/27) showed isosignal (type B), and 18.5% (5/27) showed hypersignal (type C). Within the isosignal group, 29.6% (8/27) of the inner nodules showed hyposignal (type D), 7.4% (2/27) showed isosignal (type E), and there was no hypersignal (type F). 40.7% (11/27) of the lesions were LR-4 in LI-RADS score, and 59.3% (16/27) were LR-5. There was no statistically significant difference (&lt;i&gt;P&lt;/i&gt;&gt;0.05) in the maximum diameter, enhancement pattern, and LI-RADS score of internal and external nodules between the hypo and iso signal group. Histologically, NIN-HCC showed fine trabe","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 11","pages":"989-996"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}