Correlation between peak time, peak acceleration time, enhancement rate and the degree of histological differentiation and malignant behavior of cancer cells in PLC patients
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摘要:
目的 探索超声造影测定达峰时间、峰值加速时间、增强速率与原发性肝癌患者组织学分化程度及癌细胞恶性行为的关系。 方法 选择2015年2月~2019年2月我院60例原发性肝癌患者作为研究对象，根据患者的组织分化程度，分为低分化程度患者21例，中分化程度患者19例，高分化程度患者20例。所有患者经过病理检查，Ⅰ~Ⅱ期组患者35例，Ⅲ~Ⅳ期组患者25例，淋巴转移患者32例。分析不同病理状态、组织分化程度以及淋巴转移情况的增始时间、峰值时间、峰值增强强度、增强速率以及50%倾斜率之间的差异。 结果 低分化组、高分化组以及中分化组患者的增始时间、峰值时间、峰值增强强度、增强速率以及50%倾斜率之间的差异有统计学意义（P < 0.05）。经过两两比较，患者的峰值时间、增始时间、增强速率从高到低依次为高分化组、中分化组以及低分化组；患者的峰值时间、峰值增强强度以及50%倾斜率从高到低依次为低分化组、中分化组以及高分化组。Ⅲ~Ⅳ期组患者的增始时间、增强速率显著高于Ⅰ~Ⅱ期组（P < 0.05），Ⅲ~Ⅳ期组患者的峰值时间、峰值增强强度以及50%倾斜率显著低于Ⅰ~Ⅱ期组（P < 0.05）。淋巴转移组患者的增始时间、增强速率高于淋巴未转移组，淋巴转移组患者的峰值时间、峰值增强强度以及50%倾斜率低于淋巴未转移组（P < 0.05）。患者的淋巴转移情况、病理状态以及组织分化程度分别于增始时间、增强速率呈现正相关，患者的淋巴转移情况、病理状态以及组织分化程度分别于峰值时间、峰值增强强度以及50%倾斜率呈现负相关（P < 0.05）。 结论 超声造影测定达峰时间、峰值加速时间、增强速率与原发性肝癌患者的组织学分化程度及癌细胞恶性行为显著相关。 Abstract:Objective To explore the relationship between the peak time, peak acceleration time, enhancement rate and the degree of histological differentiation and malignant behavior of cancer cells in PLC patients. Methods From February 2015 to February 2019, 60 patients with primary liver cancer were selected. According to the degree of tissue differentiation, there were 21 patients with low differentiation, 19 patients with medium differentiation, 20 patients with high differentiation. All patients underwent pathological examination, 35 patients in stage I-II, 25 patients in stage III-IV and 32 patients with lymph metastasis. To analyze the difference among the different pathological state, the degree of tissue differentiation and the condition of lymph node metastasis in the beginning time, peak time, peak enhancement intensity, enhancement rate and 50% tilt rate were compared. Results The differences of the starting time, peak time, peak enhancement intensity, enhancement rate and 50% tilt rate between the low differentiation group, the high differentiation group and the middle differentiation group were significant. The peak time, peak enhancement intensity and 50% tilt rate of the patients were divided into low differentiation group, middle differentiation group and high differentiation group. The time and rate of enhancement in the stage Ⅲ-Ⅳ group were significantly higher than those in the stage Ⅰ-Ⅱ group. The peak time, peak intensity and 50% tilt rate in the stage Ⅲ-Ⅳ group were significantly lower than those in the stage Ⅰ-Ⅱ group. The time and rate of enhancement in the stage Ⅲ-Ⅳ group were significantly higher than those in the stage Ⅰ-Ⅱ group. The peak time, peak intensity and 50% tilt rate in the stage Ⅲ-Ⅳ group were significantly lower than those in the stage Ⅰ-Ⅱ group. In the group without lymph node metastasis, the lymph node metastasis, pathological state and the degree of tissue differentiation were positively correlated with the beginning time and the rate of enhancement respectively. The lymph node metastasis, pathological state and the degree of tissue differentiation were negatively correlated with the peak time, the peak intensity of enhancement and the 50% tilt rate respectively. Conclusions The peak time, peak acceleration time and enhancement rate measured by contrast-enhanced ultrasound are significantly related to the degree of histological differentiation and malignant behavior of cancer cells in patients with primary liver cancer. -
图 1 女性，54岁，原发性肝癌高分化患者，超声造影检查可见丰富血流信号
Figure 1. A 54-year-old female patient with highly differentiated primary liver cancer has abundant blood flow signals on contrast-enhanced ultrasonography.
图 2 女性，56岁，原发性肝癌低分化患者，超声造影检查可见血流信号
Figure 2. A 56-year-old female patient with poorly differentiated primary liver cancer with blood flow signal oncontrast-enhanced ultrasound.
表 1 不同组织分化情况患者的超声参数比较
Table 1. Comparison of ultrasound parameters in patients with different tissue differentiation (Mean±SD)
组别 增始时间(s) 峰值时间(s) 峰值增强强度 增强速率 50%倾斜率 低分化组(n=21) 9.58±2.44 36.78±2.16 12.76±2.42 0.46±0.26 0.99±0.32 中分化组(n=19) 11.34±2.52 40.18±2.53 10.49±2.55 0.63±0.17 0.88±0.45 高分化组(n=20) 14.12±1.09 44.13±8.84 8.33±1.36 0.85±0.09 0.52±0.09 F 5.257 12.723 6.043 3.717 3.233 P 0.000 0.000 0.000 0.000 0.002 LSD-t(低分化vs中分化) 12.360 11.262 10.023 9.652 7.852 P 0.000 0.000 0.000 0.000 0.000 LSD-t(低分化vs高分化) 9.741 8.021 7.885 5.841 9.321 P 0.000 0.000 0.000 0.000 0.000 LSD-t(高分化vs中分化) 12.032 11.023 9.147 8.214 7.364 P 0.000 0.000 0.000 0.000 0.000 
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表 2 不同病理状态患者的超声参数比较
Table 2. Comparison of ultrasound parameters in patients with different pathological states (Mean±SD)
组别 增始时间(s) 峰值时间(s) 峰值增强强度 增强速率 50%倾斜率 Ⅲ-Ⅳ期组(n=35) 15.22±1.23 35.11±1.54 7.07±1.03 0.91±0.11 0.51±0.18 Ⅰ-Ⅱ期组(n=25) 13.45±1.01 37.34±1.17 9.11±1.09 0.79±0.14 0.62±0.10 t 9.450 6.088 7.383 3.717 3.021 P 0.000 0.000 0.000 0.000 0.004
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表 3 不同淋巴转移情况患者的超声参数比较
Table 3. Comparison of ultrasound parameters in patients with different lymphatic metastasis (Mean±SD)
组别 增始时间(s) 峰值时间(s) 峰值增强强度 增强速率 50%倾斜率 淋巴转移组(n=32) 15.41±1.40 36.19±1.41 7.55±1.09 0.98±0.15 0.44±0.52 淋巴未转移组(n=28) 12.99±1.15 38.15±1.19 9.44±1.15 0.82±0.22 0.69±0.19 t 7.251 5.772 6.531 3.245 2.533 P 0.000 0.000 0.000 0.000 0.015
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表 4 各指标相关性分析
Table 4. Correlation analysis of the indexes
指标 增始时间(s) 峰值时间(s) 峰值增强强度 增强速率 50%倾斜率 淋巴转移情况 r 0.523 -0.423 -0.623 0.412 -0.449 P 0.000 0.000 0.000 0.000 0.000 病理状态 r 0.412 -0.421 -0.365 0.399 -0.497 P 0.000 0.000 0.000 0.000 0.000 组织分化程度 r 0.412 -0.521 -0.254 0.527 -0.581 P 0.000 0.000 0.000 0.000 0.000
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