| Objective:In this study,the main purpose was to retrospectively analyze the data of clinical case,imaging,laboratory and pathological in hepatocellular carcinoma patients,and to describe imaging features,the value of tumor biomarkers in serum,pathological grade,Ki-67 expression and correlation between them,we tried to apply non-invasive methods such as medical image features and serum tumor biomarker to evaluate the pathological grade,preliminarily determine the degree of malignancy of the tumor.Methods:In this study,we selected patients who were diagnosed with HCC in a top three hospital in Qiqihar from January 2015 to December 2017.A total of 138 cases were collected,including 125 males and 13 females.General information such as the patient's age,gender,and history of hepatitis is found in the medical records or outpatient visits.All patients underwent nuclear magnetic image?MRI?testing within1 week prior to diagnosis.The patient did not receive any treatment for HCC prior to MRI testing.The tumor size was measured,and the tumor with or without capsule,bleeding,lipids,the enhancement method and the Apparent Diffusion Coefficient?ADC?value of the parenchymal part of the tumor were observed.Immunohistochemical sections of the patient were obtained from the pathology department.Serum tumor biomarkers Alpha Fetal Protein?AFP?and Carbohydrate antigen 19-9?CA19-9?values were obtained in hospital.The patient was admitted to the hospital as a ventral blood 5 ml of venous blood through the elbow vein.After standing at room temperature for 30 minutes,the centrifuge was centrifuged for 10minutes in a 5000 r/min centrifuge.AFP and ARCHITECT chemiluminescence were used to detect AFP and CA19-9 levels.The database was built with Epidata 3.0 software,and SPSS 24.0 software was used for statistical analysis.The measurement data such as age,AFP value,CA-199value and ADC value were expressed by mean vlue±standard deviation?x±s?or M?Q25,Q75?,and the data usage rate or composition was counted.With Spearman correlation,Spearman rank correlation or Kendall rank correlation to analye the correlation between pathological grade and general patient data,serum tumor markers,imaging features,the correlation between Ki-67 expression and general data of patients,tumor biomarkers,pathological grade,imaging features;?as the test level,P<0.05 indicated that the difference was statistically significant.Results:1.The general information,serum AFP and CA19-9 values,imaging features,pathological grade and expression of Ki-67 in HCC patients.?1?the general information of HCC patients:Among 138 cases,males were much more than females,125 cases were male?90.58%?,13 cases were female?9.42%?,and the ratio of male to female was 9.62:1.Young patients?<45 years old?were the least,there were 22?15.94%?,57?41.31%?middle-aged patients?4559 years old?,and 59?42.75%?elder patients?60 years old and above?.?2?Personal history of HCC patients and past history of hepatitis:There were 67 cases with smoking history in 138 cases?48.55%?,71 cases without smoking history?51.45%?,the ratio of the two was 1.06:1.There 72 cases with alcohol intake history?52.17%?,66 cases without alcohol intake?47.83%?,the ratio of the two was 1.09:1.Among the cases,there were 117cases with?84.78%?hepatitis,and 21cases without hepatitis?15.22%?,the ratio of the two was 5.57:1.?3?Serum tumor biomarkers in cases with HCC:There were 74cases with negative serum AFP?53.62%?in 138 cases,and 64 cases with positive serum AFP?46.38%?,the ratio of them was 1.16:1.There were 117 cases with negative CA19-9?84.78%?,and 21 cases with positive CA19-9?15.22%?,the ratio of the two was 5.57:1.?4?The imaging feature of cases:Among 138 patients,there were 32 cases?23.19%?with HCC tumor<3cm,and 106 cases?76.81%?with tumor?3 cm.There were 48 cases?34.78%?with capsules and 90 cases?65.22%?without capsules.There were 34 cases?26.64%?with bleeding,and 104 patients?75.36%?without bleeding.There were 44 cases?31.88%?with lipid-containing tumors and 94 cases?68.12%?without lipids.There were 127 cases?92.03%?with multiple blood supply and 11cases?7.97%?with less blood supply.100 cases?72.46%?were cleared from the portal vein and 38 cases?27.54%?were continuously strengthening.The ADC value ranged from 0.75×10-33 mm2/s to 1.40×10-3 mm2/s,and the median was 1.105×10-3mm2/s(1.05×10-3,1.19×10-3)mm2/s.?5?Pathological grades:Among 138 HCC cases,there were 32 cases with poor differentiation?23.19%?,80 cases with moderate differentiation?57.97%?and 26cases with high differentiation?18.84%?,the ratio of them was 1.23:3.08:1.?6?expression of Ki-67 in HCC cases:There were 44 cases?31.88%?with low expression of Ki-67 and 94 cases?68.12%?with high expression of Ki-67.The ratio of low expression and high expression of Ki-67 was 1:2.14.2.Correlation between tumor pathological grade and general condition,tumor imaging features in patients with HCCThere was no significant difference in pathological grade between the patient's gender and the patient's age?P>0.05?.There was no significant difference in the presence or absence of tumors with tumors?P>0.05?.There was a statistically significant difference in tumor size,presence or absence of bleeding,and presence or absence of lipids?P<0.05?.There was difference between tumor enhancement mode was significant?P<0.05?.Pathological grade was positively correlated with tumor ADC value?P<0.05?.3.Correlation between Ki-67 expression and general condition,serum tumor biomarkers,case grading and tumor imagingThere was no significant difference between the expression of Ki-67 and the gender and age?P>0.05?.There was no significance between Ki-67 expression and serum tumor markers,tumor size,presence or absence of capsules,blood supply?P>0.05?.There were T significant difference between Ki-67 expression and pathological grade,presence or absence of bleeding,presence or absence of lipids,and tumor enhancement?P<0.05?.Ki-67 expression was negatively correlated with tumor ADC values?P<0.05?.Conclusion:1.The maximum diameter of tumor in HCC cases was generally?3cm.MRI images showed that most of the HCC tumors had not capsules,bleeding and the enhanced imaging showed that the tumors was multi-blood Donors,while the portal vein and lag phase were usually cleared.2.MRI images of HCC patients showed that the tumor had hemorrhage,no lipid,and the pathology was poorly differentiated.The immunohistochemical Ki-67 was highly expressed;the pathology was poorly differentiated when the tumor was?3 cm;the MRI image showed no hemorrhage or fat in the tumor.The pathology was highly differentiated when quality and persistence were strengthened,and Ki-67 was lowly expressed by immunohistochemistry.The pathology was highly differentiated when the tumor was<3 cm.3.Pathology was positively correlated with ADC values.Ki-67 expression was negatively correlated with ADC values. |
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