| Part 1 Difference of cell proliferation and microvessel density between hepatocellular carcinoma and other hepatic lesionsObjective:To study the difference of cell proliferation and microvessel density(MVD) between hepatocellular carcinoma(HCC) and other hepatic lesions. Methods:331 specimens,including 115 HCCs,6 combined hepatocellular and cholangiocarcinoma,14 cholangiocellular carcinoma,3 focal nodular hyperplasia(FNH),2 hepatocellular adenoma,4 necrotic liver carcinoma, 3 chronic liver abscess, 3 coagulation necrosis,4 adenomatous hyperplasia,2 angiomyolipoma,6 inflammatory pseudotumor,1 fibroinflamtory necrotic nodu,1 eosinophilic granuloma,1 neurofibroma,98 cirrhosis adjacent to malignant tumor,12 cirrhosis adjacent to benign lesion,34 normal liver parenchyma adjacent to malignant tumor and 22 normal liver parenchyma adjacent to benign lesion,were immunohistochemically stained by monoclonal antibody Ki-67 and monoclonal antibody CD34,respectively.The expression of Ki-67 and MVD were statistically analysed among different diseases and diameters,respectively. Results:The expression of Ki-67 in HCC were 26.51%,which was much higher than those in benign lesions(P<0.001).The MVD of HCC was 47.74±23.56,which was statistically no more than that of adenomatous hyperplasia(P=0.147),but much higher than those of cirrhosis or normal liver parenchyma(P<0.001).There was difference of MVD among HCCs of difference diameters(P=0.027). Conclusion:Cell proliferation is an important criterion for distinguishing HCC from benign lesions and MVD is useful in discovering precancerous lesions from cirrhosis or normal liver parenchyma.Part 2 Magnetic resonance imaging(MRI) of hepatocellular carcinoma and other hepatic lesions and relationship between the imaging and biological characterObjective:To study dynamic enhanced magnetic resonance imaging(MRI) of HCC and other hepatic lesions and relationship between the MRI and the MVD or the expression of Ki-67 for macro-evaluating biological character of the lesions with imagings. Methods:157 hepatic lesions,including 109 HCC,6 combined hepatocellular and cholangiocarcinoma,12 cholangiocellular carcinoma,3 focal nodular hyperplasia(FNH),2 hepatocellular adenoma,4 necrotic liver carcinoma,3 chronic liver abscess,3 coagulation necrosis,4 adenomatous hyperplasia,2 angiomyolipoma,6 inflammatory pseudotumor,1 fibroinflamtory necrotic nodu,1 eosinophilic granuloma and 1 neurofibroma,underwent dynamic enhanced MRI examination before surgry.All specimens were immunohistochemically stained by monoclonal antibody Ki-67 and monoclonal antibody CD34,respectively.Features on MR imagings of those lesions were observed and contrast-to-noise ratios(CNR) in all phase were calculated.Pearson correlation was performed for correlation analysis between the CNRs and microvessel density.The volume doubling time of two HCCs were calculated. Results:Typical HCC enhancement pattern was strong and early enhancement and hypointense to the liver at the end.CNRs of HCC were all correlative with MVD in all phases(P<0.05),but CNRs of other lesions were not. The volume doubling time and Ki-67 expression of the two HCCs were 95.51 days and 33%;57.44 days and 44%, respectively. Conclusion:Dynamic enhanced MRI is of full value in demonstrating HCC and is useful in macro-evaluating MVD of HCC.Cell proliferation may be shown by followed MRI examinations.Part 3 Optimal sequence for dynamic enhanced MRI in diagnosis of HCCObjective:To evaluate the value of three-dimensional(3D) sequence for dynamic enhanced MRI in diagnosis of HCC. Methods:63 patients were underwent 2D and 3D dynamic enhanced MRI during successive two days,respectively.Lesion visibilities with different diameters were compared between the two sequences.Liver-to-noise signal ratio(SNRl),aorta-to-noise signal ratio(SNRa) and lesion-liver contrast-to-noise ratios(CNR) with different diameters in all phase were calculated and compared between the two sequences,respectively.Multiple planar reconstruction(MPR) and maxim...
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