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目的探讨肝细胞肝癌(HCC)计算机断层扫描(CT)三期动态增强动脉期强化特点与肿瘤病理分化程度的相关性。方法选择2012年8月至2014年8月间收治的70例HCC患者(73个病灶),根据患者病理分化程度分为高分化组、中分化组和低分化组,分析HCC增强CT的特点和HCC肿瘤大小与病理分化程度的关系。结果高分化组患者的瘤实质强化比例高于中分化组及低分化组,而瘤血管强化比例低于中分化组及低分化组,差异均有统计学意义(均P<0.05)。各组的无明显强化比例之间差异无统计学意义(P>0.05)。高分化组肿瘤大小≥5 cm的比例少于中分化组与低分化组,差异均有统计学意义(均P<0.05)。中分化组肿瘤大小≥5 cm的比例与低分化组相比,差异无统计学意义(P>0.05)。各组肿瘤大小≤3 cm及3~5 cm的比例之间差异均无统计学意义(均P>0.05)。Pearson相关分析结果显示,瘤实质强化与肿瘤病理分化程度呈正相关,瘤血管强化与肿瘤病理分化程度呈负相关,而肿瘤大小与肿瘤病理分化程度无明显相关性。结论 HCC患者经CT三期的动态增强扫描显示的动脉期强化特点与其肿瘤病理分化程度具有紧密联系,值得临床重视。
Objective To investigate the correlation between enhanced stage of arterial phase and differentiation of hepatocellular carcinoma (HCC) by phase Ⅲ dynamic enhancement of computed tomography (CT). Methods Seventy HCC patients (73 lesions) who were admitted to our hospital from August 2012 to August 2014 were divided into well-differentiated group, moderately differentiated group and poorly differentiated group according to the degree of pathological differentiation. The characteristics of HCC- Relationship between HCC tumor size and pathological differentiation. Results The percentage of tumor parenchyma in well-differentiated group was higher than that in moderately differentiated group and poorly differentiated group, while the proportion of tumor vessels in well-differentiated group was lower than that in moderately differentiated group and poorly differentiated group (all P <0.05). There was no significant difference between the two groups (P> 0.05). The proportion of tumor size≥5 cm in well-differentiated group was less than that in moderately differentiated group and poorly differentiated group (all P <0.05). The proportion of tumor size≥5 cm in the moderately differentiated group was not significantly different from that in the poorly differentiated group (P> 0.05). The tumor size ≤ 3 cm and the proportion of 3 ~ 5 cm in each group had no significant difference (all P> 0.05). The results of Pearson correlation analysis showed that tumor parenchyma enhancement was positively correlated with the degree of tumor pathological differentiation. There was a negative correlation between tumor angiogenesis and tumor pathological differentiation. There was no significant correlation between tumor size and tumor pathological differentiation. Conclusions The dynamic phase contrast enhanced CT scan of HCC patients shows the close relationship between the enhancement of arterial phase and the degree of tumor differentiation. It deserves clinical attention.