细胞角蛋白19阳性肝细胞癌与常规肝细胞癌及肝内胆管癌的ct影像特征比较。

IF 2.3 2区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Quantitative Imaging in Medicine and Surgery Pub Date : 2025-08-01 Epub Date: 2025-07-29 DOI:10.21037/qims-24-914
Hongbin Zhang, Lintao Chen, Jing Zhang, Ziqian Li, Yifan Wang, Fangyu Sun, Wenting Du, Xiuming Zhang, Wenjie Liang
{"title":"细胞角蛋白19阳性肝细胞癌与常规肝细胞癌及肝内胆管癌的ct影像特征比较。","authors":"Hongbin Zhang, Lintao Chen, Jing Zhang, Ziqian Li, Yifan Wang, Fangyu Sun, Wenting Du, Xiuming Zhang, Wenjie Liang","doi":"10.21037/qims-24-914","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cytokeratin 19-positive hepatocellular carcinoma (CK19<sup>+</sup> HCC) is an uncommon subtype of hepatocellular carcinoma (HCC). The purpose of this study was to identify radiological characteristics with diagnostic value for CK19<sup>+</sup> HCC.</p><p><strong>Methods: </strong>This was a case-control study. A retrospective analysis of 104 patients with surgically resected, pathologically confirmed CK19<sup>+</sup> HCC was conducted. The contrast-enhanced computed tomography characteristics of the enrolled patients were assessed, and differences in characteristics between groups were identified by statistical analysis. A multivariate logistic regression model was established to identify CK19<sup>+</sup> HCC, and receiver operating characteristic curves were plotted to evaluate the diagnostic performance of the model.</p><p><strong>Results: </strong>The univariate analysis revealed that the frequency of regular morphology (55.8% <i>vs.</i> 35.6%, P<0.001), hypodensity (99.0% <i>vs.</i> 91.8%, P=0.010), intratumoral necrosis (61.5% <i>vs.</i> 25.0%, P<0.001), heterogeneous enhancement (96.2% <i>vs.</i> 86.5%, P=0.008), peripheral washout (5.8% <i>vs.</i> 1.4%, P=0.031), non-peripheral washout (88.5% <i>vs.</i> 45.7%, P<0.001), Liver Imaging Reporting and Data System category 5 (67.3% <i>vs.</i> 40.4%, P<0.001), and Liver Imaging Reporting and Data System - Category tumor in vein (LR-TIV) (16.3% <i>vs.</i> 2.4%, P<0.001) were significantly higher in CK19<sup>+</sup> HCC than the non-CK19+ hepatic tumor patients. Conversely, the incidence of rim enhancement in the arterial phase (7.7% <i>vs.</i> 22.6%, P=0.001), transient hepatic attenuation difference (THAD; 4.8% <i>vs.</i> 23.1%, P<0.001), pseudocapsule formation (12.5% <i>vs.</i> 23.6%, P=0.021), progressive enhancement (5.8% <i>vs.</i> 50.5%, P<0.001), and lymphadenopathy (9.6% <i>vs.</i> 24.5%, P=0.002) was significantly lower in the CK19<sup>+</sup> HCC than the non-CK19<sup>+</sup> hepatic tumor patients. The multivariate analysis identified intratumoral necrosis, THAD, pseudocapsule formation, progressive enhancement, and LR-TIV as independent predictors of CK19+ HCC (P<0.05). The joint prediction model had an area under the curve of 0.867 in terms of its ability to detect CK19<sup>+</sup> HCC, and a sensitivity of 88.46% and a specificity of 69.71%.</p><p><strong>Conclusions: </strong>CK19<sup>+</sup> HCC is characterized by an increased prevalence of intratumoral necrosis and LR-TIV, as well as a lower incidence of THAD, pseudocapsule formation, and progressive enhancement, which collectively contribute to the identification of this HCC variant.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 8","pages":"7470-7482"},"PeriodicalIF":2.3000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332676/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparing the computed tomography radiologic features of cytokeratin 19-positive hepatocellular carcinoma to those of conventional hepatocellular carcinoma and intrahepatic cholangiocarcinoma.\",\"authors\":\"Hongbin Zhang, Lintao Chen, Jing Zhang, Ziqian Li, Yifan Wang, Fangyu Sun, Wenting Du, Xiuming Zhang, Wenjie Liang\",\"doi\":\"10.21037/qims-24-914\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cytokeratin 19-positive hepatocellular carcinoma (CK19<sup>+</sup> HCC) is an uncommon subtype of hepatocellular carcinoma (HCC). The purpose of this study was to identify radiological characteristics with diagnostic value for CK19<sup>+</sup> HCC.</p><p><strong>Methods: </strong>This was a case-control study. A retrospective analysis of 104 patients with surgically resected, pathologically confirmed CK19<sup>+</sup> HCC was conducted. The contrast-enhanced computed tomography characteristics of the enrolled patients were assessed, and differences in characteristics between groups were identified by statistical analysis. A multivariate logistic regression model was established to identify CK19<sup>+</sup> HCC, and receiver operating characteristic curves were plotted to evaluate the diagnostic performance of the model.</p><p><strong>Results: </strong>The univariate analysis revealed that the frequency of regular morphology (55.8% <i>vs.</i> 35.6%, P<0.001), hypodensity (99.0% <i>vs.</i> 91.8%, P=0.010), intratumoral necrosis (61.5% <i>vs.</i> 25.0%, P<0.001), heterogeneous enhancement (96.2% <i>vs.</i> 86.5%, P=0.008), peripheral washout (5.8% <i>vs.</i> 1.4%, P=0.031), non-peripheral washout (88.5% <i>vs.</i> 45.7%, P<0.001), Liver Imaging Reporting and Data System category 5 (67.3% <i>vs.</i> 40.4%, P<0.001), and Liver Imaging Reporting and Data System - Category tumor in vein (LR-TIV) (16.3% <i>vs.</i> 2.4%, P<0.001) were significantly higher in CK19<sup>+</sup> HCC than the non-CK19+ hepatic tumor patients. Conversely, the incidence of rim enhancement in the arterial phase (7.7% <i>vs.</i> 22.6%, P=0.001), transient hepatic attenuation difference (THAD; 4.8% <i>vs.</i> 23.1%, P<0.001), pseudocapsule formation (12.5% <i>vs.</i> 23.6%, P=0.021), progressive enhancement (5.8% <i>vs.</i> 50.5%, P<0.001), and lymphadenopathy (9.6% <i>vs.</i> 24.5%, P=0.002) was significantly lower in the CK19<sup>+</sup> HCC than the non-CK19<sup>+</sup> hepatic tumor patients. The multivariate analysis identified intratumoral necrosis, THAD, pseudocapsule formation, progressive enhancement, and LR-TIV as independent predictors of CK19+ HCC (P<0.05). The joint prediction model had an area under the curve of 0.867 in terms of its ability to detect CK19<sup>+</sup> HCC, and a sensitivity of 88.46% and a specificity of 69.71%.</p><p><strong>Conclusions: </strong>CK19<sup>+</sup> HCC is characterized by an increased prevalence of intratumoral necrosis and LR-TIV, as well as a lower incidence of THAD, pseudocapsule formation, and progressive enhancement, which collectively contribute to the identification of this HCC variant.</p>\",\"PeriodicalId\":54267,\"journal\":{\"name\":\"Quantitative Imaging in Medicine and Surgery\",\"volume\":\"15 8\",\"pages\":\"7470-7482\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332676/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Quantitative Imaging in Medicine and Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/qims-24-914\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Quantitative Imaging in Medicine and Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/qims-24-914","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/29 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0

摘要

背景:细胞角蛋白19阳性肝细胞癌(CK19+ HCC)是一种罕见的肝细胞癌(HCC)亚型。本研究的目的是确定CK19+ HCC的放射学特征和诊断价值。方法:采用病例-对照研究。回顾性分析104例手术切除、病理证实的CK19+ HCC患者。评估入组患者的ct增强特征,并通过统计分析确定组间特征的差异。建立多元logistic回归模型识别CK19+ HCC,绘制受试者工作特征曲线评价模型的诊断效能。结果:单因素分析显示,P+肝癌患者的形态规则发生率(55.8%比35.6%,Pvs. 91.8%, P=0.010)、瘤内坏死发生率(61.5%比25.0%,Pvs. 86.5%, P=0.008)、外周洗脱(5.8%比1.4%,P=0.031)、非外周洗脱(88.5%比45.7%,Pvs. 40.4%, Pvs. 2.4%)高于非ck19 +肝肿瘤患者。相反,动脉期边缘增强的发生率(7.7% vs. 22.6%, P=0.001)、一过性肝衰减差(THAD;CK19+ HCC患者的进行性增强(5.8% vs. 50.5%, pv vs. 24.5%, P=0.002)显著低于非CK19+肝肿瘤患者。多变量分析发现,肿瘤内坏死、THAD、假包膜形成、进行性强化和LR-TIV是CK19+ HCC (P+ HCC)的独立预测因子,敏感性为88.46%,特异性为69.71%。结论:CK19+ HCC的特点是肿瘤内坏死和LR-TIV的发生率增加,THAD、假包膜形成和进行性强化的发生率较低,这些共同有助于识别这种HCC变体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Comparing the computed tomography radiologic features of cytokeratin 19-positive hepatocellular carcinoma to those of conventional hepatocellular carcinoma and intrahepatic cholangiocarcinoma.

Comparing the computed tomography radiologic features of cytokeratin 19-positive hepatocellular carcinoma to those of conventional hepatocellular carcinoma and intrahepatic cholangiocarcinoma.

Comparing the computed tomography radiologic features of cytokeratin 19-positive hepatocellular carcinoma to those of conventional hepatocellular carcinoma and intrahepatic cholangiocarcinoma.

Background: Cytokeratin 19-positive hepatocellular carcinoma (CK19+ HCC) is an uncommon subtype of hepatocellular carcinoma (HCC). The purpose of this study was to identify radiological characteristics with diagnostic value for CK19+ HCC.

Methods: This was a case-control study. A retrospective analysis of 104 patients with surgically resected, pathologically confirmed CK19+ HCC was conducted. The contrast-enhanced computed tomography characteristics of the enrolled patients were assessed, and differences in characteristics between groups were identified by statistical analysis. A multivariate logistic regression model was established to identify CK19+ HCC, and receiver operating characteristic curves were plotted to evaluate the diagnostic performance of the model.

Results: The univariate analysis revealed that the frequency of regular morphology (55.8% vs. 35.6%, P<0.001), hypodensity (99.0% vs. 91.8%, P=0.010), intratumoral necrosis (61.5% vs. 25.0%, P<0.001), heterogeneous enhancement (96.2% vs. 86.5%, P=0.008), peripheral washout (5.8% vs. 1.4%, P=0.031), non-peripheral washout (88.5% vs. 45.7%, P<0.001), Liver Imaging Reporting and Data System category 5 (67.3% vs. 40.4%, P<0.001), and Liver Imaging Reporting and Data System - Category tumor in vein (LR-TIV) (16.3% vs. 2.4%, P<0.001) were significantly higher in CK19+ HCC than the non-CK19+ hepatic tumor patients. Conversely, the incidence of rim enhancement in the arterial phase (7.7% vs. 22.6%, P=0.001), transient hepatic attenuation difference (THAD; 4.8% vs. 23.1%, P<0.001), pseudocapsule formation (12.5% vs. 23.6%, P=0.021), progressive enhancement (5.8% vs. 50.5%, P<0.001), and lymphadenopathy (9.6% vs. 24.5%, P=0.002) was significantly lower in the CK19+ HCC than the non-CK19+ hepatic tumor patients. The multivariate analysis identified intratumoral necrosis, THAD, pseudocapsule formation, progressive enhancement, and LR-TIV as independent predictors of CK19+ HCC (P<0.05). The joint prediction model had an area under the curve of 0.867 in terms of its ability to detect CK19+ HCC, and a sensitivity of 88.46% and a specificity of 69.71%.

Conclusions: CK19+ HCC is characterized by an increased prevalence of intratumoral necrosis and LR-TIV, as well as a lower incidence of THAD, pseudocapsule formation, and progressive enhancement, which collectively contribute to the identification of this HCC variant.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Quantitative Imaging in Medicine and Surgery
Quantitative Imaging in Medicine and Surgery Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
4.20
自引率
17.90%
发文量
252
期刊介绍: Information not localized
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信