Relationship Of Quantitative Perfusion Of Contrast Enhanced Ultrasound On Hepatocellular Carcinoma With Expression Of Angiogenesis Related Factors And Recurrence After Ablation

Objective:To investigate the relationship of contrast enhanced ultrasound on hepatocellularcarcinoma with expression of basic fibroblast growth factor (bFGF) and ET-1, and therelationship of contrast enhanced ultrasound with recurrence after ablation. And toprovide the theory basis for noninvasively and effectively predicting recurrence aftertreatment by the quantitative parameters of contrast enhanced ultrasound.Materials and methods:61patients with single HCC lesion histopathologically proven without metastasis andvascular invasion or bile invasion were enrolled in the study, whose maximal diameterof tumor was no more than5cm. All patients, with liver function of Child A or B,without other diseases as cardiovascular and kidney diseases, had not accepted anytherapy before enrolled in the study. Then the microwave and radiofrequency ablationswere performed. Contrast enhanced ultrasound were performed before treatment and onevery follow-up:1week,1month,3months after treatment,6months after treatment,and the following every6months. The quantitative parameters of CEUS were acquiredby Sonoliver. CT or MRI was performed before treatment. Biopsy guided by real timeultrasound was performed to get tumor specimens before ablation for all patients.Immunohistochemical stains were performed on23patients. All cases were divided into2groups: recurrence and non-recurrence group. The quantitative parameters of CEUS,tumor bFGF and ET-1expression were compared in these two groups. Then therecurrence group was divided into two groups: early recurrence group and laterecurrence group. The quantitative parameters of CEUS and the relationship betweenthem was analyzed. Finally the relationship among the parameters of CEUS, tumorbFGF/ET-1expression and recurrence were statistically analyzed. Results:(1) In the quantitative parameters of CEUS before treatment, t RT, t TTP, tPI and t-pPIof recurrence group were significantly less than that of non-recurrence group(P<0.05);(2) t RT, t TTP of early recurrence group were significantly less than that ofnon-recurrence group(P<0.05), tPI and t-pPI of late recurrence group were significantlyless than that of non-recurrence group(P<0.05);(3) bFGF expression of recurrence group was significantly higher than that ofnon-recurrence group (P=0.036);(4) t TTP showed a significantly inverse correlation with tumor bFGF (r=-0.347,P=0.04);(5) Logistic regression showed that t RT, t TTP and t PI were related to recurrence afterablation and t PI was risk factor for both recurrence and late recurrence.Conclusions:(1) In the parameters of CEUS before treatment, t RT, t TTP, t PI and t-p PI are relatedto recurrence after ablation on HCC.(2) t RT and t TTP are related to early recurrence while t PI and t-pPI are related to laterecurrence.(3) bFGF expression in tumor before treatment on HCC with recurrence are higher thanthose of patients without recurrence.(4) In the parameters of CEUS on HCC, t TTP could evaluate bFGF expression of tumor,and could effectively predict recurrence after ablation.(5) CEUS is a noninvasive, effective method which could evaluate angiogenesis ofHCC and predict the recurrence and prognosis.