肝细胞癌经动脉化疗栓塞术后脂碘染色的定量评估：它能预测肿瘤复发吗？

Q2 Pharmacology, Toxicology and Pharmaceutics

F1000Research Pub Date : 2024-07-08 DOI:10.12688/f1000research.147694.1

T. Wattanasatesiri, Patcha Faimetta, Wirana Angthong

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引用次数: 0

摘要

背景传统经动脉化疗栓塞术（cTACE）后瘤内脂碘醇染色程度可预测肿瘤反应和疾病预后。本研究旨在通过定量评估肿瘤内脂碘醇滞留与 cTACE 完全反应和肿瘤复发之间的相关性。方法自 2013 年 1 月至 2023 年 9 月，对所有接受 cTACE 治疗的 HCC 患者进行识别。纳入标准为 HCC≤6 个且大小为 1-6 厘米的患者，至少有一个肿瘤在 cTACE 后获得完全应答，且有可用的基线和随访 CT 检查。对肿瘤、cTACE 程序和脂碘染色参数进行了分析。通过单变量和多变量分析，确定了与肿瘤复发相关的重要因素。通过 ROC 曲线分析，确定了预测肿瘤复发的有统计学意义因素的最佳临界点。结果最终研究对象包括 39 名患者，63 例 HCC。平均 27.8 个月后，63 例患者中有 18 例（28.6%）发现肿瘤复发。单变量分析显示，肿瘤复发的发生率随肿瘤大小的增加而显著增加（p = 0.007），不均匀的脂碘染色模式（p6.44 HU/月）是预测 cTACE 完全反应后 HCC 复发的因素。这些相关性可为后续的成像监测和治疗方法提供有用的指导。

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Quantitative assessment of the lipiodol staining after transarterial chemoembolization for hepatocellular carcinoma: can it predict tumor recurrence?

Background The degree of intratumoral lipiodol staining after conventional transarterial chemoembolization (cTACE) has the potential to predict tumor responses and disease prognosis. This study is aimed at evaluating the correlation between the lipiodol retention of the tumor with a complete response after cTACE and tumor recurrence by quantitative assessment. Methods From January 2013 to September 2023, every patient receiving cTACE for HCC was recognized. Inclusion criteria were patients with ≤6 HCCs and sizes 1-6 cm, with at least one tumor obtaining a complete response after cTACE, and available baseline and follow-up CT studies. Tumoral, cTACE procedural, and lipiodol staining parameters were analyzed. Using univariate and multivariate analysis, significant factors associated with tumor recurrence were identified. ROC curve analysis was used to identify the optimal cutoff point for the statistically significant factors, predicting tumor recurrence. Results The final population included 39 patients with 63 HCCs. Tumor recurrence was detected in 18/63 (28.6%) at a mean of 27.8 months. On univariate analysis, the incidence of tumor recurrence significantly increased with increased tumor size (p = 0.007), an inhomogeneous lipiodol staining pattern (p<0.001), a low minimum lipiodol radiodensity (p = 0.012), and a high lipiodol washout rate (p = 0.046). On multivariate analysis, an inhomogeneous lipiodol staining pattern (p<0.001) and a high lipiodol washout rate (p = 0.012) were significant predictors for tumor recurrence. On ROC analysis, a lipiodol washout rate of greater than 6.44 HU/month was related to tumor recurrence (sensitivity 83%, specificity 51%). Conclusions Inhomogeneous lipiodol staining pattern and lipiodol washout rate of >6.44 HU/month were predictors for recurrence of HCC after a complete response after cTACE. These correlations may provide useful guidance for subsequent imaging surveillance and treatment approaches.

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来源期刊

F1000Research Pharmacology, Toxicology and Pharmaceutics-Pharmacology, Toxicology and Pharmaceutics (all)

CiteScore

5.00

自引率

0.00%

发文量

1646

审稿时长

1 weeks

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