Correlation Of MRI Findings,pathological Differentiation With GPC3,CD34,CK19,CK7 Expression And Prognosis In Patients With Hepatocellular Carcinomas

Objective: To explore the correlation between magnetic resonance imaging findings of hepatocellular carcinoma and the expression of GPC3,CD34,CK19 and CK7.Correlation between the expression of GPC3,CD34,CK19 and CK7 with the degree of pathological differentiation of HCC was analyzed.Multivariate analysis of the MRI findings and the degree of pathological differentiation affecting the prognosis of HCC patients.Methods:(1)A total of 112 HCC patients with complete clinical data and imaging data were collected from February 2018 to October 2019 in Affiliated Hospital of Youjiang Medical University for Nationalities and from July 2014 to October 2019 in The People's Hospital of Guangxi Zhuang Autonomous Region.Preoperative MRI plain scan and enhanced examination were performed,and postoperative pathological examination was performed to detect the expression of GPC3,CD34,CK19 and CK7 in the cancer tissues.The correlation between the preoperative MRI findings of all HCC lesions and the expression of GPC3,CD34,CK19 and CK7 in the postoperative cancer tissues was analyzed,and the non-conditional Logsitic analysis affecting the expression of GPC3,CD34,CK19 and CK7 was performed.(2)The correlation between HCC differentiation and GPC3,CD34,CK19 and CK7 expression was analyzed.(3)According to the method of regular follow-up and reexamination,71 patients were followed up.All the patients were followed up with complete imaging follow-up data,and the follow-up time of the patients was recorded statistically.Univariate Kaplan-Meier analysis was performed on the prognosis of 71 HCC patients,and multivariate COX regression analysis was performed on the prognosis of HCC.Results:(1)The positive expression rate of CD34 in HCC was 73.21%.Whether HCC is accompanied by cirrhosis is correlated with the expression of CD34,and the difference is statistically significant(p < 0.05).The positive rate of CD34 expression in HCC with cirrhosis was 79.75%,higher than 57.58% in HCC without cirrhosis.HCC with cirrhosis is an independent risk factor for CD34 expression(p=0.02,OR=2.90).The positive expression rate of CK19 in HCC was 20.54%.The size of HCC,whether accompanied by lymph node enlargement,necrotic cystic degeneration,or tumor embolism,were correlated with the expression of CK19,and the differences were statistically significant(p < 0.05).The positive rate of CK19 expression was 31.75% in > 3cm HCC,which was higher than 6.12% in ?3cm HCC;the positive rate of CK19 expression in HCC with enlarged lymph nodes was 42.86%,which was higher than that in HCC without enlarged lymph nodes 15.38%;the positive rate of CK19 expression in HCC with necrotic cystic degeneration was 44.83%,higher than that in HCC without necrotic cystic degeneration 12.05%;the positive rate of CK19 expression was33.33% in HCC with thromboembolism,which was higher than 14.47% in HCC without thromboembolism.HCC with enlarged lymph nodes is an independent risk factor for CK19expression(p=0.014,OR=5.23).HCC with necrotic cystic degeneration was an independent risk factor for CK19 expression(p=0.005,OR=4.32).The positive expression rate of CK7 in HCC was 28.57%.There was a significant correlation between the expression of CK7 and the presence or absence of lymph node enlargement(p < 0.05);The positive rate of CK7 expression was 47.62% in HCC with enlarged lymph nodes,and 24.18% in HCC with high and no enlarged lymph nodes.HCC with enlarged lymph nodes was an independent risk factor for CK7 expression(p=0.04,OR=2.85).MRI showed no statistically significant correlation between HCC size,T1 WI,T2WI,marginal,enlarged lymph nodes,blood supply type,cirrhosis,pseudocapsule,intratumoral cystic necrosis,tumor embolism,and GPC3expression(p >0.05).(2)The expression of GPC3 was correlated with the degree of differentiation of HCC,and the difference was statistically significant(p<0.05).The positiverates of GPC3 expression in moderately and poorly differentiated HCC were 96.39% and78.95%,respectively,higher than the positive rates of GPC3 expression in highly differentiated HCC 40%.The expression of CK19 was correlated with the degree of differentiation of HCC,and the difference was statistically significant(p < 0.05).The positive rate of CK19 expression in poorly differentiated HCC was 42.11%,higher than that of14.46% and 30% in moderately and highly differentiated HCC.(3)The prognosis of HCC patients was correlated with MRI findings of HCC margins,lymph node enlargement,cirrhosis,and tumor embolism,with statistically significant differences(p < 0.05).Patients with HCC with blurred margins have poorer prognosis than those with clear margins;patients with HCC complicated with enlarged lymph nodes have poorer prognosis than those without enlarged lymph nodes;patients with HCC complicated with cirrhosis have poorer prognosis than those without cirrhosis;and patients with HCC complicated with thromboembolism have poorer prognosis than those without thromboembolism.Multivariate analysis showed that HCC with cirrhosis was an independent risk factor for the prognosis of HCC patients(p=0.035,RR=0.41).HCC with tumor thrombi was an independent risk factor for HCC prognosis(p=0.029,RR=3.53).Conclusion: The MRI imaging findings could preliminarily evaluate the biological characteristics of HCC.The MRI findings of HCC were closely correlated with the expression of the markers CD34,CK19 and CK7.(2)The expression of GPC3 is closely related to the degree of HCC differentiation.GPC3-positive HCC has a low degree of differentiation and a high degree of malignancy,GPC3 is a marker that can be used to assess HCC progression and proliferation.The expression of CK19 is closely related to the degree of HCC differentiation,CK19 positive HCC has a low degree of differentiation and a strong ability of invasion and metastasis,CK19 is a marker that can be used to assess the aggressiveness and metastasis of HCC.(3)MRI showed that the patients with blurred tumor margins,enlarged lymph nodes,cirrhosis,and tumor thrombi had poor prognosis.HCC with cirrhosis and thromboembolismwere independent risk factors for prognosis.