磁共振成像对结直肠癌肝转移瘤病理组织学生长方式的鉴别

肝脏 ›› 2022, Vol. 27 ›› Issue (9): 990-993.

磁共振成像对结直肠癌肝转移瘤病理组织学生长方式的鉴别

顾芸睿, 顾季镛

226100 江苏南通市海门区人民医院影像科

收稿日期:2022-04-15 出版日期:2022-09-30 发布日期:2022-10-27
通讯作者: 顾季镛,Email:gujiyong930@126.com

The value of magnetic resonance imaging in differentiating the histopathological growth patterns of Liver metastases of colorectal cancer

GU Yun-rui, GU Ji-yong

Department of Image, Nantong Haimen District People's Hospital, Jiangsu 226100, China

Received:2022-04-15 Online:2022-09-30 Published:2022-10-27
Contact: GU Ji-yong,Email:gujiyong930@126.com

摘要/Abstract

摘要： 目的评价MRI对结直肠癌肝转移(CRLM)患者病理组织学生长方式(HGP)类型的鉴别。方法收集2010年1月—2022年1月期间海门区人民医院收治的经病理确诊并进行手术完整切除的42例CRLM患者临床病理资料,平均年龄(59.4 ± 8.5)岁,其中男性25例、女性17例。根据国际专家共识标准,CRLM患者中肝转移瘤促纤维组织增生、替代或推挤等组织学生长方式具备优势(>50%)时,分别分类为dHGP、rHGP或pHGP;当dHGP、rHGP或pHGP类型均<50%时,定义为混合型HGP。比较不同HGP类型CRLM患者临床资料,绘制ROC曲线计算诊断AUC值。结果 42例CRLM患者中dHGP、rHGP及pHGP分别为20例、11例及11例,无混合型HGP病例。比较rHGP和非rHGP(dHGP、pHGP)一般资料,可知肝转移瘤位置、病理类型、T分期及N分期差异均不具有统计学意义(P>0.05)。比较rHGP、非rHGP型CRLM MRI表现,rHGP和非rHGP型增强前后肿瘤直径差为(0.30 ± 0.12)cm、(0.08 ± 0.03)cm,差异具有统计学意义(P<0.05);rHGP和非rHGP型CRLM边缘强化分别为11例(100%)、14例(45.2%),差异具有统计学意义(P<0.05)。联合增强前后肿瘤直径差、边缘强化来区分rHGP、非rHGP。绘制ROC曲线,增强前后肿瘤直径差、边缘强化联合诊断rHGP CRLM患者时AUC值为0.852(95% CI: 0.718～0.986)。结论与dHGP、pHGP型相比,rHGP CRLM更易出现MRI边缘强化,同时增强后肿瘤直径也显著增加。联合增强前后肿瘤直径差、边缘强化等MRI特征可有效区分rHGP、非rHGP CRLM病例。

关键词: 结直肠癌肝转移, 病理组织学生长方式, 边缘强化

Abstract: Objective To evaluate the value of magnetic resonance imaging (MRI) in differentiating the type of histopathological growth patterns (HGP) of patients with liver metastases of colorectal cancers (CRLM). Methods From January 2010 to January 2022, the clinical and pathological data of 42 patients with CRLM that were confirmed by pathological observation on surgical resection tissues were collected. The average age was (59.4 ± 8.5) years old, including 25 males and 17 females. According to the international expert consensus standard, when there is an advantage (>50%) in promoting the proliferation, replacement or pushing of fibrous tissue in HGPs of CRLM patients, it is classified as promoting the proliferation of desmoplastic HGP (dHGP), replacement HGP (rHGP) or pushing HGP (pHGP), respectively. When the type of dHGP, rHGP or pHGP is less than 50%, it is defined as mixed HGP. The clinical data of CRLM patients with different HGP types were compared, followed by ROC curve analysis and the calculation of diagnostic AUC value. Results Among 42 CRLM patients, dHGP, rHGP and pHGP were 20 cases, 11 cases and 11 cases, respectively, and there was no mixed HGP case. When comparing the general data of rHGP and non-rHGP (dHGP, pHGP), there was no significant difference in the location, pathological type, T stage and N stage of liver metastases (P>0.05). Comparing the MRI findings of CRLM patients with rHGP and non-rHGP, the tumor diameters before and after enhancement was (0.30 ± 0.12) cm and (0.08 ± 0.03) cm, respectively, which had statistically significant difference (P<0.05). There were 11 cases (100%) and 14 cases (45.2%) of rim enhancement in the rHGP and non-rHGP patients, respectively, with statistically significant difference (P<0.05). The AUC value for the combination of the tumor diameter difference before and after enhancement with rim enhancement for distinguishing rHGP from non-rHGP was 0.852 (95% CI: 0.718 ~ 0.986). Conclusion Compared with dHGP and pHGP, rHGP CRLM is more prone to MRI rim enhancement, and the tumor diameter is also significantly increased after enhancement. MRI features such as the difference of tumor diameter before and after enhancement can effectively distinguish rHGP and non-rHGP CRLM patients.

Key words: Colorectal liver metastases, Histopathological growth patterns, Rim enhancement

顾芸睿, 顾季镛. 磁共振成像对结直肠癌肝转移瘤病理组织学生长方式的鉴别[J]. 肝脏, 2022, 27(9): 990-993.

GU Yun-rui, GU Ji-yong. The value of magnetic resonance imaging in differentiating the histopathological growth patterns of Liver metastases of colorectal cancer[J]. Chinese Hepatolgy, 2022, 27(9): 990-993.

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