CT Value Of Portal Phase Non-invasive Evaluation Of PVTT Blood Supply And Its Different Blood Supply Degree For TACE Efficacy And Survival Analysis

Part ? CT value of portal phase non-invasive evaluation of PVTT blood supply and the optimal cut-off valueObjective:1.To establish a system for non-invasive assessing the blood supply of PVTT.2.To determine the optimal cut-off value of different blood supply levels.Methods:A retrospective analysis of 42 patients with hepatocellular carcinoma(HCC)and PVTT who underwent surgery was performed at the Affiliated Tumor Hospital of Guangxi Medical University between January2014 and December 2017.Based on the standard of MVD,the correlation between the MVD of PVTT tissue and the portal phase CT value of preoperative PVTT and evaluating the blood supply of PVTT were analyzed.The ROC curve was used to determine the cut-off value.Results:1.Measurement results of MVD and portal phase CT values:1)The average MVD of PVTT detected by CD34 was 14.64±5.62/400*HPF,and the average MVD detected by CD31 was 13.24±5.47/400*HPF.There was a statistical difference(t=-6.433,P<0.01).2)The results of three methods for measuring the CT value of portal phase were:63.95±14.91 Hu,63.65±15.02Hu,63.63±15.24 Hu,the difference was not statistically significant(F=0.006,P>0.05).2.The mean portal phase CT value and CD34-detected MVD were highly positively correlated in assessing PVTT blood supply(R~2=0.581,F=55.44,P<0.001).The optimal cut-off value is 81.35Hu to distinguish different blood supply levels.Conclusion:CT value of portal phase and MVD are highly consistent in assessing blood supply of PVTT.We can use the CT value of portal phase instead of MVD to evaluation the blood supply of PVTT non-invasively and the optimal cut-off value is 81.35Hu.Part ? Therapeutic response and clinical prognosis of patients with HCC and different blood supply levels of PVTT treated with TACEObjective: To investigate the response and survival time of TACE in patients with HCC with different blood supply levels of PVTT.Methods: A retrospective analysis of 148 patients with HCC-PVTT who underwent TACE treatment was performed at the Affiliated Tumor Hospital of Guangxi Medical University between January 2014 and December 2017.Based on the cut-off value of portal phase CT value,the patients were divided into the blood-less group(36 cases)and the blood-rich group(112 cases).Compare the differences in therapeutic response and survival time between the two groups.Results: The ORR(12.50% vs 5.56%,P<0.01)and DCR(51.79% vs22.22%,P<0.01)of the blood-rich group were significantly superior to the blood-less group and the median survival time was longer(4.4 months vs 3.4months,P < 0.05).The number of TACE treatments is increasing in the blood-rich group and the MST can be significantly prolonged(10.2 months vs2.4 months,P<0.01).Conclusion: The therapeutic response and median survival time of TACE in the blood-rich group were significantly better than those in the blood-less group.Increasing the number of TACE treatments can significantly prolong the median survival time of the blood-rich group.