Abstract
Background: Hepatocellular carcinoma (HCC) is one of the most deadly malignant tumors in China. Microvascular invasion (MVI) of HCC often indicates poor prognosis and metastasis. 18F-FDG PET-CT is a new imaging method commonly used to screen tumor occurrence and evaluate tumor stage.
Purpose: The study attempted to predict the occurrence of MVI in HCC early through 18F-FDG PET/CT imaging findings and laboratory data.
Patients and methods: A total of 113 patients who accord with the inclusion criteria were divided into two groups based on postoperative pathological: MVI-positive group and MVI-negative group. We retrospectively analyzed the imaging findings and laboratory data of 113 patients. Imaging findings included tumor size, tumor maximum standard uptake value (SUVmaxT), normal liver maximum standard uptake value (SUVmaxL). calculate the ratio of SUVmaxT and SUVmaxL (SUVmaxT/L) and SUVmaxT/L>2 was defined as an active tumor metabolism. The tumor size was indicated by the maximum diameter of the tumor, with a diameter more than 5cm was defined as a mass lesion. laboratory data included alpha-fetoprotein (AFP) value and HBeAg level. AFP>20ug/L was defined as AFP high level. HBeAg>0.03NCU/mL was defined as HB-positive.
Result: SUVmaxT/L (p=0.003), AFP level (P=0.008) and tumor size (P=0.015) were statistically different between the two groups. Active tumor metabolism, mass lesion and AFP high level tend to be MVI positive. The consequences of binary logistic regression analysis verified active tumor metabolism (OR=4.124, 95%CI, 1.566-10.861, p=0.004) and high AFP level (OR=2.702, 95%CI, 1.214-6.021, p=0.015) were independent risk factors for MVI. The sensitivity of the combination of these two independent risk factors to predict HCC with MVI is 56.9% (29/51), the specificity is 83.9% (52/62) and the accuracy is 71.7% (81/113).
Conclusion: active tumor metabolism and high AFP level can predict the occurrence of MVI of HCC.