Predictive Value of Conventional Ultrasound and Contrast-Enhanced Ultrasound in Early Recurrence of Hepatocellular Carcinoma after Surgical Resection

Abstract The goals of the work described here were to study the pre-operative risk factors associated with early recurrence (ER) of hepatocellular carcinoma (HCC) after surgical resection and discuss the value of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in predicting ER o...

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Veröffentlicht in:Ultrasound in medicine & biology 2016-05, Vol.42 (5), p.1042-1048
Hauptverfasser: Wang, Yibin, Liao, Jintang, Qi, Wenjun, Xie, Lulu, Li, Yueyi
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creator Wang, Yibin
Liao, Jintang
Qi, Wenjun
Xie, Lulu
Li, Yueyi
description Abstract The goals of the work described here were to study the pre-operative risk factors associated with early recurrence (ER) of hepatocellular carcinoma (HCC) after surgical resection and discuss the value of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in predicting ER of HCC, so as to provide more information for optimizing clinical treatment and improving prognosis. A retrospective analysis was conducted on 59 patients who underwent both US and CEUS examinations pre-operatively and surgical resection for HCC between December 2010 and January 2014 in our hospital. The patients' clinical data, laboratory examination data and ultrasonic imaging diagnostic data were collected. Univariate analysis and logistic regression analysis were performed to determine the independent risk factors for ER of HCC after surgical resection. Diagnostic values of independent risk factors in predicting ER were further evaluated. The 59 patients were divided into the ER group (27 cases) and ER-free group (32 cases). There were no significant differences in age and sex between the two groups ( p  > 0.05). Univariate analysis revealed that differences in pre-operative serum α-fetoprotein level ≥400 ng/mL ( p  = 0.008), tumor diameter ≥5 cm ( p  = 0.012), macroscopic vascular invasion ( p  = 0.040), “fast wash-out” enhancement pattern ( p  = 0.006) and inhomogeneous distribution of contrast agent ( p  = 0.031) statistically significantly differed between the two groups. Logistic regression analysis indicated that pre-operative serum AFP level ≥400 ng/mL ( p  = 0.024), tumor diameter ≥5 cm ( p  = 0.042) and “fast wash-out” enhancement pattern ( p  = 0.009) were independent risk factors for ER of HCC; macrovascular invasion ( p  = 0.095) and inhomogeneous distribution of contrast agent ( p  = 0.628) did not statistically significantly differ between two groups ( p  = 0.628). Predictive values of the independent risk factors were further evaluated. The sensitivity of a “fast wash-out” enhancement pattern in predicting ER of HCC post-operatively did not statistically differ from that of tumor diameter ≥5 cm ( p  > 0.05), whereas it was significantly higher than the sensitivities of the other predictive indexes ( p  
doi_str_mv 10.1016/j.ultrasmedbio.2015.12.010
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A retrospective analysis was conducted on 59 patients who underwent both US and CEUS examinations pre-operatively and surgical resection for HCC between December 2010 and January 2014 in our hospital. The patients' clinical data, laboratory examination data and ultrasonic imaging diagnostic data were collected. Univariate analysis and logistic regression analysis were performed to determine the independent risk factors for ER of HCC after surgical resection. Diagnostic values of independent risk factors in predicting ER were further evaluated. The 59 patients were divided into the ER group (27 cases) and ER-free group (32 cases). There were no significant differences in age and sex between the two groups ( p  &gt; 0.05). Univariate analysis revealed that differences in pre-operative serum α-fetoprotein level ≥400 ng/mL ( p  = 0.008), tumor diameter ≥5 cm ( p  = 0.012), macroscopic vascular invasion ( p  = 0.040), “fast wash-out” enhancement pattern ( p  = 0.006) and inhomogeneous distribution of contrast agent ( p  = 0.031) statistically significantly differed between the two groups. Logistic regression analysis indicated that pre-operative serum AFP level ≥400 ng/mL ( p  = 0.024), tumor diameter ≥5 cm ( p  = 0.042) and “fast wash-out” enhancement pattern ( p  = 0.009) were independent risk factors for ER of HCC; macrovascular invasion ( p  = 0.095) and inhomogeneous distribution of contrast agent ( p  = 0.628) did not statistically significantly differ between two groups ( p  = 0.628). Predictive values of the independent risk factors were further evaluated. The sensitivity of a “fast wash-out” enhancement pattern in predicting ER of HCC post-operatively did not statistically differ from that of tumor diameter ≥5 cm ( p  &gt; 0.05), whereas it was significantly higher than the sensitivities of the other predictive indexes ( p  &lt; 0.05). A pre-operative serum α-fetoprotein level ≥400 ng/mL, tumor diameter ≥5 cm and “fast wash-out” enhancement pattern are independent risk factors for ER of HCC after surgical resection. In addition, the “fast wash-out” enhancement pattern could probably be used to screen populations at high risk of recurrence owing to its high sensitivity in predicting ER of HCC post-operatively. All these findings provide beneficial information for management of HCC.</description><identifier>ISSN: 0301-5629</identifier><identifier>EISSN: 1879-291X</identifier><identifier>DOI: 10.1016/j.ultrasmedbio.2015.12.010</identifier><identifier>PMID: 26803390</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Age Distribution ; Carcinoma, Hepatocellular - diagnostic imaging ; Carcinoma, Hepatocellular - epidemiology ; Carcinoma, Hepatocellular - surgery ; China - epidemiology ; Contrast Media ; Contrast-enhanced ultrasound ; Early Detection of Cancer - methods ; Female ; Hepatocellular carcinoma ; Humans ; Image Enhancement - methods ; Incidence ; Liver Neoplasms - diagnostic imaging ; Liver Neoplasms - epidemiology ; Liver Neoplasms - surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local - diagnostic imaging ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - prevention &amp; control ; Phospholipids ; Prognosis ; Radiology ; Recurrence ; Reproducibility of Results ; Retrospective Studies ; Risk Assessment - methods ; Risk factor ; Sensitivity and Specificity ; Sex Distribution ; Sulfur Hexafluoride ; Treatment Outcome ; Tumor Burden ; Ultrasonography - methods ; Ultrasonography - statistics &amp; numerical data ; Ultrasound</subject><ispartof>Ultrasound in medicine &amp; biology, 2016-05, Vol.42 (5), p.1042-1048</ispartof><rights>World Federation for Ultrasound in Medicine &amp; Biology</rights><rights>2016 World Federation for Ultrasound in Medicine &amp; Biology</rights><rights>Copyright © 2016 World Federation for Ultrasound in Medicine &amp; Biology. 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All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c534t-7857751f73fc48ebbab4a36a3fcce4acdefc34b1d7508f9a912ad8c26885a1d93</citedby><cites>FETCH-LOGICAL-c534t-7857751f73fc48ebbab4a36a3fcce4acdefc34b1d7508f9a912ad8c26885a1d93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ultrasmedbio.2015.12.010$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26803390$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Yibin</creatorcontrib><creatorcontrib>Liao, Jintang</creatorcontrib><creatorcontrib>Qi, Wenjun</creatorcontrib><creatorcontrib>Xie, Lulu</creatorcontrib><creatorcontrib>Li, Yueyi</creatorcontrib><title>Predictive Value of Conventional Ultrasound and Contrast-Enhanced Ultrasound in Early Recurrence of Hepatocellular Carcinoma after Surgical Resection</title><title>Ultrasound in medicine &amp; biology</title><addtitle>Ultrasound Med Biol</addtitle><description>Abstract The goals of the work described here were to study the pre-operative risk factors associated with early recurrence (ER) of hepatocellular carcinoma (HCC) after surgical resection and discuss the value of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in predicting ER of HCC, so as to provide more information for optimizing clinical treatment and improving prognosis. A retrospective analysis was conducted on 59 patients who underwent both US and CEUS examinations pre-operatively and surgical resection for HCC between December 2010 and January 2014 in our hospital. The patients' clinical data, laboratory examination data and ultrasonic imaging diagnostic data were collected. Univariate analysis and logistic regression analysis were performed to determine the independent risk factors for ER of HCC after surgical resection. Diagnostic values of independent risk factors in predicting ER were further evaluated. The 59 patients were divided into the ER group (27 cases) and ER-free group (32 cases). There were no significant differences in age and sex between the two groups ( p  &gt; 0.05). Univariate analysis revealed that differences in pre-operative serum α-fetoprotein level ≥400 ng/mL ( p  = 0.008), tumor diameter ≥5 cm ( p  = 0.012), macroscopic vascular invasion ( p  = 0.040), “fast wash-out” enhancement pattern ( p  = 0.006) and inhomogeneous distribution of contrast agent ( p  = 0.031) statistically significantly differed between the two groups. Logistic regression analysis indicated that pre-operative serum AFP level ≥400 ng/mL ( p  = 0.024), tumor diameter ≥5 cm ( p  = 0.042) and “fast wash-out” enhancement pattern ( p  = 0.009) were independent risk factors for ER of HCC; macrovascular invasion ( p  = 0.095) and inhomogeneous distribution of contrast agent ( p  = 0.628) did not statistically significantly differ between two groups ( p  = 0.628). Predictive values of the independent risk factors were further evaluated. The sensitivity of a “fast wash-out” enhancement pattern in predicting ER of HCC post-operatively did not statistically differ from that of tumor diameter ≥5 cm ( p  &gt; 0.05), whereas it was significantly higher than the sensitivities of the other predictive indexes ( p  &lt; 0.05). A pre-operative serum α-fetoprotein level ≥400 ng/mL, tumor diameter ≥5 cm and “fast wash-out” enhancement pattern are independent risk factors for ER of HCC after surgical resection. In addition, the “fast wash-out” enhancement pattern could probably be used to screen populations at high risk of recurrence owing to its high sensitivity in predicting ER of HCC post-operatively. All these findings provide beneficial information for management of HCC.</description><subject>Age Distribution</subject><subject>Carcinoma, Hepatocellular - diagnostic imaging</subject><subject>Carcinoma, Hepatocellular - epidemiology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>China - epidemiology</subject><subject>Contrast Media</subject><subject>Contrast-enhanced ultrasound</subject><subject>Early Detection of Cancer - methods</subject><subject>Female</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Image Enhancement - methods</subject><subject>Incidence</subject><subject>Liver Neoplasms - diagnostic imaging</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - diagnostic imaging</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - prevention &amp; control</subject><subject>Phospholipids</subject><subject>Prognosis</subject><subject>Radiology</subject><subject>Recurrence</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Risk factor</subject><subject>Sensitivity and Specificity</subject><subject>Sex Distribution</subject><subject>Sulfur Hexafluoride</subject><subject>Treatment Outcome</subject><subject>Tumor Burden</subject><subject>Ultrasonography - methods</subject><subject>Ultrasonography - statistics &amp; numerical data</subject><subject>Ultrasound</subject><issn>0301-5629</issn><issn>1879-291X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNksFu1DAQhi0EokvhFZDFiUu2dpzECQcktCwUqRKopYibNbEn4CVrb-1kpX0Q3he7W1DFqQfLsuaf-T3zDSGvOFtyxpuzzXIepwBxi6a3flkyXi95uWScPSIL3squKDv-_TFZMMF4UTdld0KexbhhjMlGyKfkpGxaJkTHFuT3l4DG6snukX6DcUbqB7rybo9ust7BSK9vvfzsDIV0Uiy_p2LtfoLTaO4LrKNrCOOBXqKeQ8AUz_XOcQeT1ziO8wiBriBo6_wWKAwTBno1hx9WJ6tLjKiz7XPyZIAx4ou7-5Rcf1h_XZ0XF58_flq9uyh0LaqpkG0tZc0HKQZdtdj30FcgGkhPjRVog4MWVc-NrFk7dNDxEkyrU_dtDdx04pS8PtbdBX8zY5zU1sb8T3Do56i47FjXVE3FHyCVksm6kTJJ3xylOvgYAw5qF-wWwkFxpjJBtVH3CapMUPFSJYIp-eWdz9yn8L_Uv8iS4P1RgGkwe4tBRW3zpI0NaXrKePswn7f_ldGjdRnDLzxg3Pg5JPqpLxVTgrrKu5RXiddpi0TViD_Yusyb</recordid><startdate>20160501</startdate><enddate>20160501</enddate><creator>Wang, Yibin</creator><creator>Liao, Jintang</creator><creator>Qi, Wenjun</creator><creator>Xie, Lulu</creator><creator>Li, Yueyi</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope></search><sort><creationdate>20160501</creationdate><title>Predictive Value of Conventional Ultrasound and Contrast-Enhanced Ultrasound in Early Recurrence of Hepatocellular Carcinoma after Surgical Resection</title><author>Wang, Yibin ; Liao, Jintang ; Qi, Wenjun ; Xie, Lulu ; Li, Yueyi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c534t-7857751f73fc48ebbab4a36a3fcce4acdefc34b1d7508f9a912ad8c26885a1d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Age Distribution</topic><topic>Carcinoma, Hepatocellular - diagnostic imaging</topic><topic>Carcinoma, Hepatocellular - epidemiology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>China - epidemiology</topic><topic>Contrast Media</topic><topic>Contrast-enhanced ultrasound</topic><topic>Early Detection of Cancer - methods</topic><topic>Female</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Image Enhancement - methods</topic><topic>Incidence</topic><topic>Liver Neoplasms - diagnostic imaging</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - diagnostic imaging</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - prevention &amp; control</topic><topic>Phospholipids</topic><topic>Prognosis</topic><topic>Radiology</topic><topic>Recurrence</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Risk factor</topic><topic>Sensitivity and Specificity</topic><topic>Sex Distribution</topic><topic>Sulfur Hexafluoride</topic><topic>Treatment Outcome</topic><topic>Tumor Burden</topic><topic>Ultrasonography - methods</topic><topic>Ultrasonography - statistics &amp; numerical data</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Yibin</creatorcontrib><creatorcontrib>Liao, Jintang</creatorcontrib><creatorcontrib>Qi, Wenjun</creatorcontrib><creatorcontrib>Xie, Lulu</creatorcontrib><creatorcontrib>Li, Yueyi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Ultrasound in medicine &amp; biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Yibin</au><au>Liao, Jintang</au><au>Qi, Wenjun</au><au>Xie, Lulu</au><au>Li, Yueyi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive Value of Conventional Ultrasound and Contrast-Enhanced Ultrasound in Early Recurrence of Hepatocellular Carcinoma after Surgical Resection</atitle><jtitle>Ultrasound in medicine &amp; biology</jtitle><addtitle>Ultrasound Med Biol</addtitle><date>2016-05-01</date><risdate>2016</risdate><volume>42</volume><issue>5</issue><spage>1042</spage><epage>1048</epage><pages>1042-1048</pages><issn>0301-5629</issn><eissn>1879-291X</eissn><abstract>Abstract The goals of the work described here were to study the pre-operative risk factors associated with early recurrence (ER) of hepatocellular carcinoma (HCC) after surgical resection and discuss the value of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in predicting ER of HCC, so as to provide more information for optimizing clinical treatment and improving prognosis. A retrospective analysis was conducted on 59 patients who underwent both US and CEUS examinations pre-operatively and surgical resection for HCC between December 2010 and January 2014 in our hospital. The patients' clinical data, laboratory examination data and ultrasonic imaging diagnostic data were collected. Univariate analysis and logistic regression analysis were performed to determine the independent risk factors for ER of HCC after surgical resection. Diagnostic values of independent risk factors in predicting ER were further evaluated. The 59 patients were divided into the ER group (27 cases) and ER-free group (32 cases). There were no significant differences in age and sex between the two groups ( p  &gt; 0.05). Univariate analysis revealed that differences in pre-operative serum α-fetoprotein level ≥400 ng/mL ( p  = 0.008), tumor diameter ≥5 cm ( p  = 0.012), macroscopic vascular invasion ( p  = 0.040), “fast wash-out” enhancement pattern ( p  = 0.006) and inhomogeneous distribution of contrast agent ( p  = 0.031) statistically significantly differed between the two groups. Logistic regression analysis indicated that pre-operative serum AFP level ≥400 ng/mL ( p  = 0.024), tumor diameter ≥5 cm ( p  = 0.042) and “fast wash-out” enhancement pattern ( p  = 0.009) were independent risk factors for ER of HCC; macrovascular invasion ( p  = 0.095) and inhomogeneous distribution of contrast agent ( p  = 0.628) did not statistically significantly differ between two groups ( p  = 0.628). Predictive values of the independent risk factors were further evaluated. The sensitivity of a “fast wash-out” enhancement pattern in predicting ER of HCC post-operatively did not statistically differ from that of tumor diameter ≥5 cm ( p  &gt; 0.05), whereas it was significantly higher than the sensitivities of the other predictive indexes ( p  &lt; 0.05). A pre-operative serum α-fetoprotein level ≥400 ng/mL, tumor diameter ≥5 cm and “fast wash-out” enhancement pattern are independent risk factors for ER of HCC after surgical resection. In addition, the “fast wash-out” enhancement pattern could probably be used to screen populations at high risk of recurrence owing to its high sensitivity in predicting ER of HCC post-operatively. All these findings provide beneficial information for management of HCC.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>26803390</pmid><doi>10.1016/j.ultrasmedbio.2015.12.010</doi><tpages>7</tpages></addata></record>
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subjects Age Distribution
Carcinoma, Hepatocellular - diagnostic imaging
Carcinoma, Hepatocellular - epidemiology
Carcinoma, Hepatocellular - surgery
China - epidemiology
Contrast Media
Contrast-enhanced ultrasound
Early Detection of Cancer - methods
Female
Hepatocellular carcinoma
Humans
Image Enhancement - methods
Incidence
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - epidemiology
Liver Neoplasms - surgery
Male
Middle Aged
Neoplasm Recurrence, Local - diagnostic imaging
Neoplasm Recurrence, Local - epidemiology
Neoplasm Recurrence, Local - prevention & control
Phospholipids
Prognosis
Radiology
Recurrence
Reproducibility of Results
Retrospective Studies
Risk Assessment - methods
Risk factor
Sensitivity and Specificity
Sex Distribution
Sulfur Hexafluoride
Treatment Outcome
Tumor Burden
Ultrasonography - methods
Ultrasonography - statistics & numerical data
Ultrasound
title Predictive Value of Conventional Ultrasound and Contrast-Enhanced Ultrasound in Early Recurrence of Hepatocellular Carcinoma after Surgical Resection
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