Evaluation Of The HCC CT Classification In Liver Reserve Function Before TACE

Object iveInvestigate and study out the medthod of the hepatic carcinoma(HCC) CT classification in liver reserve function before transeatheter arterial chemoemboliation and investigation(TACE), and disguss its valuation. Analyze the influence of the portal vein tumor thrombus(PVTT) in liver reserve function before TACE.MethodsObject of study:Retrospective study of38cases with PVTT and12cases without PVTT, Prospective study of40cases with PVTT and10cases without PVTT were patients with TACE. All patients had done abdominal CT scan and dual-phase enhanced scan in one week before surgery and about one month after. This study was divided into two parts.(1)Studied out a new method of the HCC CT classification, analysised its correlation with Child-Pugh classification.Statistical analysised retrospective study of38patients (exclude12patients with PVTT) of five indicators of the CT grading of liver cirrhosis, foci diameter, foci number, average CT value of the solid component in arterial phase, the time of TACE treatment, correlation with Child-Pugh classification. Studied out the medthod of the HCC CT classification, it was based on Tu Rong’ s cirrhosis classification method, and added foci diameter, foci number, blood supply, the time of TACE treatment.Blinded analysis prospective study of40patients (exclude10patients with PVTT)preoperative and postoperative of the HCC CT classification and Child-Pugh classification. And detected ALT and AST indicator in one week before surgery,5-10days and about one month after surgery. Analysised Preoperative and postoperative of the HCC CT classification correlation with Child-Pugh classification and ALT, AST means.(2) Investigated the influence of the PVTT in liver reserve function before TACE, Analyzed the value of the new HCC CT classification.Collected all of these prospective and retrospective100cases of patients with PVTT, a total of22cases. Blinded analysis preoperative and postoperative of the HCC CT classification correlation with Child-Pugh classification and ALT, AST means. Contrasted without PVTT these indicators, and analysised their correlation.Result(1)Preoperative of the CT grading of liver cirrhosis, foci diameter, foci number, average CT value of the solid component in arterial phase, the time of TACE treatment, correlation with Child-Pugh A and B(no C-level cases, because it’s not suitable for the treatment with TACE, following the same). The respectively correlation coefficient r=0.56,0.81,0.85,0.87,0.79, P <0.0001.(2) Preoperative and postoperative of the HCC CT classification highly correlated with Child-Pugh classification(Preoperative r=0.88postoperative r=0.86, the total correlation coefficient rt=0.88, all P <0.0001). Preoperative of the HCC CT classification and Child-Pugh classification at all levels of ALT and AST mean indicators in one week before surgery,5-10days and about one month after surgery had no statistically significant(3) Comparison with-in group of PVTT, Preoperative and postoperative of the HCC CT classification Level Ⅰ correlated with Child-Pugh grade A (r0.75, P=0.006), the HCC CT classification LevelⅡ poor correlated with Child-Pugh grade B (r=0.34, P=0.544). Preoperative and postoperative of the HCC CT classification Level Ⅰ and Child-Pugh A of ALT, AST mean had no significant difference. The HCC CT classification Level Ⅱ and Child-Pugh B of ALT, AST mean difference had statistically significant. Compared between patients with PVTT and without group, Preoperative of the HCC CT classification and Child-Pugh classification highly correlated (r=0.86, P=0.136), Postoperative of they were poor correlation (r=0.55, P=0.533). Preoperative of the HCC CT classification all levels of ALT, AST mean had no significant difference; Postoperative of2-5days and one month after surgery, the difference of the HCC CT classification level Ⅰ of ALT and AST mean had not statistically significant, the HCC CT classification Level Ⅱ of ALT and AST mean difference had statistically significantConelusion(1)The new HCC CT classification and Child-Pugh classification was highly relevant, had some value in the assessment of liver reserve function before TACE.(2) The new HCC CT classification of Level Ⅱ could assess the liver reserve function of HCC with PVTT, this may be associated with all patients received Chinese medicine treatment(TCM) in this study, TCM had the positive significance to liver reserve function of Postoperative recovery;However, level Ⅱwas not correctly assess the liver reserve function in patients with PVTT. In Such patients, PVTT should be considered as risk factors for the new classification Ⅱ...