| Objective To evaluate dynamic characteristics of DWI in primaryhepatic carcinoma (PHC) before and after TACE and its pathological andmolecular mechanism.Materials and Methods DWIs were performed in 14patients(study group) associated with 15 masses of PHC within the 24-48hours before TACE, 7-10 days after TACE and 24-48 hours beforeⅡ-phase operation, respectively. The DWI signal and ADC values wereanalyzed in the zones of tumor and surrounding liver parenchyma andcorrelated with pathological findings. Immunohistochemical staining forMMP-2, TIMP-2 and bFGF were performed, respectively, in study groupand 16 patients(control group) with PHC which were untreated beforeoperations in the corresponding time period. The distinction of 3 kinds ofprotein expressions between corresponding parts in 2 groups or differentparts in one group were analyzed, and the correlation of 3 kinds of proteinexpressions with ADC values of homologous areas were analyzed instudy group, respectively.Results (1) Histologically, hypso-signal lesions showed on DWIwere viable tumor, tumor embolus in portal vein, colliquative necrosis orhemorrhage, and viable cells mostly located in tumor border, but the latertwo lesions were usually situated in tumor center. Lesions of iso-signalwere viable tumor, concretionary necrosis, hemorrhage or spuriouscapsule; However, lesions of hypo-signal were concretionary necrosis orspurious capsule. (2) Significant difference of ADC values was seenbetween zones of viable tumor or necrosis in tumor and surroundingliver parenchyma in every same periods (P＜0.05); There was no significant difference in ADC values among different periods in thecorresponding zones of viable tumor or surrounding liver parenchyma (P＞0.05), Whereas the distinction of ADC values oft he corresponding areaof tumor necrosis was significant among different periods (P＜0.05). (3)There was significant difference in ADC values of viable tumor betweenhigh and low cell differentiation tumors (P＜0.05). The distinction ofADC values of the whole tumor was significant among tumors withdifferent necrotic degrees (P＜0.05). However, there was no significantdifference in ADC values of viable tumor among tumors with otherdifferent pathological characteristics (P＞0.05). (4) Between viable tumorand surrounding liver parenchyma in study group or control group, thedistinctions of MMP-2, TIMP-2 and bFGF protein expression were allsignificant; There was significant difference in MMP-2 or TIMP-2protein expression index of viable tumor between study group and controlgroup(P＜0.05), but there was no significant difference in bFGF proteinexpression between 2 groups (P＞0.05). (5) Negative correlation wasobserved between bFGF protein expression index and ADC values ofviable tumor in study group (P＜0.05); There was no correlation betweenMMP-2 or TIMP-2 protein expression of viable tumor and ADC values ofcorresponding part in study group(P＞0.05).Conclusions (1) The DWI signal features and ADC values ofPHC after TACE are of certain characteristic, which can reflectobjectively pathological variance of tumor internal tissues in PHC treatedby TACE. DWI can identify viable and necrotic tumor tissue in PHC afterTACE. (2) ADC values of tumor are able to reflect PHC's pathologicalcharacteristics in certain degree. Through measuring ADC values oftumor, we can presume cell differentiation and necrotic degree of tumorand status of it's angiogenesis and proliferation, which is helpful for us to evaluate curative effect and prognosis of TACE.
|
PDF Full Text Request