Relation Study Of Hepatocellular Carcinoma Between CT Perfusion Imaging Characterization And DNA Proliferation

PURPOSE: To investigate the relation of hepatocellular carcinoma (HCC) between CT perfusion imaging characterization and DNA proliferation and its clinical value.METHODS: Thirty five patients with hepatocellular carcinoma (HCC) were examined by CT perfusion imaging. The patients were divided into typical group (group A) and untypical group(group B) according to time that the contrast agent began to wash out. If it was less than 50 second, the patient belonged to group A. If it was more than 50 second, the patient belonged to group B. Twenty-eight patients consisted of group A and seven patients consisted of group B. All patients were diagnosed by operations. After the contrast agent was injected into dorsum manus vein, the contrast agent enhanced beginning time, peak time, wash-out time and persistence time were recorded and statistical analysis was done. All nodes tissue was acquired by operations and the DNA content was examined by FCM. The rates of different period DNA content and the proliferation index (PI) were recorded and different groups aneuploid rates were counted. Then the statistical analysis was done. In each group of HCC, correlation analysis between enhanced persistence time and tumor cell S phase fraction, proliferation index were done. Then correlation analysis of all HCC nodes between enhanced persistence time and tumor cell S phase fraction, proliferation index were done. RESULTS: In examination of CT perfusion imaging, the beginning time of A and B group were 17. 39+6.47s and 16.41±3.59s, there was no significant difference between the two groups (P>0.05) . The peak time of A and B group were 25.45±4.83s and 26.73±6.38s, there was no significant difference between the two groups(P>0.05) . The wash-out time of two groups were 35.83±5.61s and 61. 73+8. 25s, there was significant difference (P<0.05). The persistence time of two groups were 53. 72±9.47s and 122.85±10.43s, there was significant difference between the two groups (P<0.05). In FCM examination, the tumor cell S phase fraction and proliferation index of group A were 35. 21+6.11% and 51. 42±1.59%. The tumor cell S phase fraction and proliferation index of group B were 22.19±4.52 % and 32.91±6.27%. There was significant difference between the two groups(P<0.05). The aneuploid tumor cells were found in 15 HCC nodes of group A(15/28), but there was no aneuploid cell in group B. In all thirty five HCC tumor nodes, the correlation between enhanced persistence time and tumor cell S phase fraction, proliferation index was statistical significance (P<0.05). Correlation coefficients were -0.72and—0. 80. In group A, the correlation between enhanced persistence time and tumor cell S phase fraction, proliferation index was statistical significance (P<0.05), too. Correlation coefficients were—0.47 and—0.39. But in group B, there was no significant difference between them(P>0.05). CONCLUSION: The study shows that there is negative correlation between enhanced persistence time and tumor cell S phase fraction, proliferation index in HCC nodes. The enhanced persistence time may respond the tumor malignancy to some degree. The shorter persistence time is, the more malignant the tumor is.