Clinical And Imaging Characteristics Analysis Of Hepatitis B-related Mass-forming Intrahepatic Cholangiocarcinoma

Objective To analyze the clinical,pathological and imaging characteristics of hepatitis B related mass-forming intrahepatic cholangiocarcinoma(IMCC)and non-hepatitis B-related IMCC.Methods A retrospective analysis was performed on 114 cases of IMCC confirmed by pathological diagnosis in the First Affiliated Hospital of Guangxi Medical University from January 2012 to October 2019.They underwent through multiphase contrast-enhanced CT scanning before surgery,and were divided into hepatitis B group(54 cases)and non-hepatitis B group(60 cases)according to the hepatitis B surface antigen.We compared the differences in clinical and imaging characteristics,pathological differentiations and postoperative tumor-free survival time between the two groups.Clinical characteristics included age,gender,symptoms,laboratory examinations(hepatitis B serology,tumor markers,liver fluke infection),etc.Imaging characteristics included lesion locations,morphological characteristic,enhancement features of the arterial phase,overall enhancement patterns(Ⅰtype to Ⅳ type)and the accompanying signs(surrounding bile duct stone,bile duct expansion and abdominal lymphadenopathy,etc.).According to the pathological differentiation degrees of WHO,it could be divided into high to intermediate differentiation group and low differentiation group.SPSS 22.0statistical software was used for statistical processing.Chi-square test or Fisher’s exact probability method was used for counting data.Results In terms of clinical and laboratory data of IMCC in hepatitis group and non-hepatitis group,there were statistical differences in gender,age,HBs antibody,HBc antibody,CA125 and AFP indicators.In terms of image features of two groups,comparing the charecteristics as tumor location,tumor maximum diameter,tumor density on plain-scan,the dull inferior margin of the liver,surrounding cholangiectasis,vessel invasion and whole intrahepatic bile ducts dilation was statistically significant(P<0.05),but comparing the charecteristics as tumor number,tumor shape,enhancement patterns on arterial phase,overall enhancement patterns,surrounding bile duct stone,hepatic capsular retraction,vascular tumor embolus,extrahepatic bile duct stone,gallbladder stones or gallbladder agenesis and abdominal lymph node heterogeneous enhancement was no statistically significant difference(P>0.05).Comparing the severe to moderate differentiated hepatitis group and non-hepatitis group IMCC in terms of tumor density on plain-scan and vessel invasion was statistically significant differences(P<0.05).Comparing the poorly differentiated hepatitis group and non-hepatitis group IMCC in terms of tumor density on plain-scan,vessel invasion and abdominal lymphadenopathy was statistically significant differences(P<0.05).Conclusion 1.There were some differences in age,gender,CA125,AFP indicators,lesions size and distribution site,surrounding cholangiectasis,vessel invasion and whole intrahepatic bile ducts dilation,abdominal lymph node size and enhancement characteristics between hepatitis B-related IMCC and non-hepatitis B-related IMCC.2.The clinical and imaging characteristics of hepatitis B-related IMCC can provide assistance for accurate clinical diagnosis and treatment.