Feasibility Of Early Diagnosis Hepatocellular Carcinoma With Hepatic Artery Flow Parameter And The Correlation Between Feeding Arterial Flow Parameter Of Tumor Periphery And Cancerometabasis

At present, the research on tumor growth and metabasis by ultrasound has been developed from anatomy to function, molecuiar biology and pathophysiology.The study that aims directly at early diagnosis and early prediction metastasis of hepatocellular carcinoma(HCC) by ultrasound components about researching the means are as followings:1. The dynamic changes of hepatic arterial blood flow parameters were understanded by ultrasound following the development HCC in the patients with hepatic cirrhosis. The results indicated that hepatic artery perfusion index(DPI)>24. 5% is taken as reference standard of early diagnosis of HCC, the sensitivity, specificity, positive predictive value were 91. 3%, 96. 1%, 80. 8% respectively in a retrospective study in 150 patients with hepatic cirrhosis.2. Hepatic arterial volume(HA-V) and celiac artery volume(CA-V) were detected by ultrasound in three groups: the HCC patients ,the hepatic cirrhosis patients and the health adults. Then the percentage of HA-V in CA-V(HA-V/CA-V%) was calculated. The results indicated that HA-V/CA-V% >22. 2% is taken as reference standard of early diagnosis of HCC, the correct index, concordance, positive predictive value is 0. 767, 88. 9%, 81. 3% respectively.3. PV, Vmean and PI of feeding artery in tumor periphery were detected by ultrasound in three groups: the HCC patients without metabasis, the HCC patients with intraliver metabasis and the ones with extraliver metabasis. The results indicate that PI >1. 20 of feeding artery in HCC tumor periphery is taken as reference standard of predicting the extraliver metabasis in HCC patients, the correct index, concordance,positive predictive value is 0.616, 81. 4%, 69. 8% respectively.4. The expressions of VEGF, MVD, mtsl, nm23-Hl, STAT1(STAT2) , hMLHl (hMSH2) in HCC tumor and the expression of SICAM-1, VEGF in peripheral blood were detected by immunohistochemistry staining , RT-PCR or radioimmunoassy in fore groups: the HCC patients without metabasis , the HCC patients with intraliver metabasis , the ones with extraliver metabasis and the control group. The results indicated as followings: the expression of VEGF, MVD, mtsl, nm23-Hl, STAT1 (STAT2) , hMLHl (hMSH2) were related with HCC metastasis. HCC with intraliver metabasis and extraliver metastasis could not be distinguished by VEGF, nm23-Hl and hMLHl(hMSH2) , but they could be distinguished by MVD and mtsl. STAT1 ( STAT2 ) could predict extraliver metastasis. If the expression of VEGF>409. 5 pg/ml in peripheral blood is taken as reference standard of predicting the occurrence of extraliver metastasis, the correct index, concordance and positive predictive value were 0.642, 81.4%, 68.1% respectively in a retrospective in 113 HCC patients 5. It were analyzed the correlation between PI of feeding artery in tumor periphery and MVD in tumor and the consistency between PI and VEGF in peripheral blood in predicting HCC metabasis. The results indicated that there was a positive correlation between feeding arterial PI in HCC tumor periphery and MVD in HCC tumor (r =0. 674, R0. 05, Y=A. 608J+28. 764). There was no difference in the correct index, concordance and positive predictive value in predicting HCC mstastasis between VEGF in peripheral blood and feeding arterial PI(P>0. 05), and the consistency between the two methods was 80.5%. So, it came true of predicting the potentiality of HCC metabasis by ultrasound pretherapy.