Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death. Abdominal ultrasound (US) is by far the most widely used first-level exam for the diagnosis of HCC. We aimed to assess whether different ultrasound patterns were related to tumor prognosis. Methods: We retrospectively reviewed all patients with a new diagnosis of HCC (single nodule) and undergoing radiofrequency thermal ablation (RFTA) at our clinic between January 2009 and December 2021. Patients were classified according to four HCC ultrasound patterns: 1A, single capsulated nodule; 1B, well capsulated intra-node nodule; 1C, cluster consisting of capsulated nodules; and 2, non-capsulated nodule. Results: 149 patients were analysed; median follow-up time was 43 months. US patterns 1A (32.9%) and 1B (61.1%) were the most commonly seen. Median overall survival (OS) and recurrence-free survival (RFS) from RFTA were 54 months (95% CI, 42–66) and 22 months (95% CI, 12–32), respectively. Pattern 1A showed the best OS. Compared to pattern 1A, 1B was independently associated with worse OS (51 months (95% CI, 34–68) vs. 46 months (95% CI, 18–62)) and RFS (34 months (95% CI, 27–41) vs. 18 months (95% CI, 12–24)). Patterns 1C and 2 were associated with worse RFS compared to 1A, while no difference was seen for OS. Among baseline clinical variables, pattern 1B exhibited higher histological grade (p= 0.048) and tumor dimension (p= 0.034) compared to pattern 1A. Conclusions: Our findings demonstrate that different US patterns correlate with different survival outcomes and tumor behavior in patients with HCC. Prospective studies are needed to confirm these results.
背景：肝细胞癌（HCC）是癌症相关死亡的主要原因。腹部超声（US）是目前诊断HCC最广泛使用的一线检查方法。本研究旨在评估不同的超声模式是否与肿瘤预后相关。方法：我们回顾性分析了2009年1月至2021年12月期间在我院新诊断为HCC（单发结节）并接受射频热消融（RFTA）治疗的所有患者。根据四种HCC超声模式对患者进行分类：1A型，单发有包膜结节；1B型，包膜内结节；1C型，由多个有包膜结节组成的簇状结构；2型，无包膜结节。结果：共分析了149例患者；中位随访时间为43个月。超声模式1A（32.9%）和1B（61.1%）最为常见。RFTA后的中位总生存期（OS）和无复发生存期（RFS）分别为54个月（95% CI，42–66）和22个月（95% CI，12–32）。1A型显示出最佳的总生存期。与1A型相比，1B型与较差的OS（51个月（95% CI，34–68）对比46个月（95% CI，18–62））和RFS（34个月（95% CI，27–41）对比18个月（95% CI，12–24））独立相关。与1A型相比，1C型和2型与较差的RFS相关，而OS未见差异。在基线临床变量中，与1A型相比，1B型表现出更高的组织学分级（p=0.048）和肿瘤尺寸（p=0.034）。结论：我们的研究结果表明，不同的超声模式与HCC患者不同的生存结局和肿瘤行为相关。需要前瞻性研究来证实这些结果。
Ultrasound Patterns of Hepatocellular Carcinoma and Their Prognostic Impact: A Retrospective Study
肿瘤(癌症)患者之家