Abstract: Objective To analyze the relationship between liver imaging reporting and data system (LI-RADS) categories on contrast-enhanced ultrasound (CEUS) and the differentiation degree and glypican-3 (GPC3) index of hepatocellular carcinoma (HCC). Methods Retrospective selection of 132 patients with surgical treatment of HCC in shenmu city hospital from January 2020 to December 2024 was involved. The clinical data of the patients were recorded, including LI-RADS category, differentiation degree, GPC3 index, etc. The clinical data of patients with different LI-RADS categories were analyzed. Kendall's tau-b correlation analysis was used to analyze the relationship between the LI-RADS categories and the degree of differentiation and the expression of GPC3 index. Results There was no significant difference in gender, age, body mass indecx (BMI), lesion location, tumor diameter, lesion number, microvascular invasion, and the Child-Pugh grade among patients with different LI-RADS differentiation on CEUS (P>0.05). The proportions of low, moderate and high differentiation in class M patients were 28.57% (6/21), 42.86% (9/21) and 28.57% (6/21), respectively. The proportions of low, moderate and high differentiation of the three types of patients were 0.00% (0/7), 28.57% (2/7) and 71.43% (5/7), respectively. The proportions of patients with low, moderate and high differentiation were 22.73% (5/22), 31.82% (7/22) and 45.45% (10/22), respectively. The proportions of low, moderate and high differentiation of the five types of patients were 42.68% (35/82), 37.80% (31/82) and 19.51% (16/82), respectively. There were statistically significant differences in LI-RADS classification and differentiation degree of contrast-enhanced ultrasound (P<0.05). The Kendall tau's - b correlation analysis revealed a negative correlation between LI-RADS classification on CEUS, (tau-b=-0.174, P=0.002). The positive and negative proportions of GPC3 index in patients with type M were 57.14% (12/21) and 42.86% (9/21), respectively. The proportions of GPC3 positive and negative in the three groups were 28.57% (2/7) and 71.43% (5/7), respectively. The positive and negative proportions of GPC3 index in the four groups were 72.73% (16/22) and 27.27% (6/22), respectively. The positive and negative proportions of GPC3 index in the 5 groups were 84.31% (66/82) and 15.69% (16/82), respectively. There were significant differences in the expression of GPC3 index and LI-RADS classification of CEUS (P<0.05). Kendall's tau-b correlation analysis showed that LI-RADS classification was positively correlated with GPC3 index (tau-b=0.227, P<0.001). Conclusion Different LI-RADS classification of CEUS was negatively correlated with the differentiation of HCC patients, and positively correlated with GPC3 index. The higher the LI-RADS category of CEUS, the lower the degree of differentiation and the stronger the expression of GPC3 index.

Key words: Hepatocellular carcinoma, Degree of differentiation, Contrast-enhanced ultrasound, Liver imaging reporting and data management system, Glypican 3