title: Quantitative Contrast-Enhanced Ultrasonic Imaging Reflects Microvascularization in Hepatocellular Carcinoma and Prognosis after Resection.
abstract: Our aim was to evaluate the correlation between tumor vasculature detected by pre-surgical contrast-enhanced ultrasonography and the post-surgical prognosis of patients with hepatocellular carcinoma. One hundred ninety-five patients with hepatocellular carcinoma who had undergone curative resection and pre-operative contrast-enhanced ultrasonography were enrolled. Intra-tumoral microvessels were evaluated by immunohistochemical staining for anti-CD31 and anti-CD34. On the basis of the immunohistochemical staining and morphology patterns, tumors were divided into capillary-like and sinusoid-like microvessel subtypes. The rise time of tumors was shorter in the capillary-like microvessel subtype than in the sinusoid-like microvasculature subtype (p = 0.026). Intra-tumor microvascular density (p < 0.001, hazard ratio = 0.137) and rise time (p = 0.006, hazard ratio = 2.475) were independent factors corresponding to different microvasculature types. Microvascular density, vascular invasion and wash-in perfusion index were determined to be independent factors in recurrence-free survival and overall survival. In conclusion, contrast-enhanced ultrasonography may serve as a means of non-invasive assessment of tumor angiogenesis and may be associated with the survival of patients with hepatocellular carcinoma after resection.
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Ultrasound, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Ru-Hai
authors.initials: RH
authors.lastname: Zou
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Ultrasound, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Qing-Guang
authors.initials: QG
authors.lastname: Lin
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Xiao-Ling
authors.initials: XL
authors.lastname: Li
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Molecular and Cellular Oncology, M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Ultrasound, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Zhou
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Ultrasound, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: An-Hua
authors.initials: AH
authors.lastname: Li
authors.affiliation: Department of Molecular and Cellular Oncology, M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Beretta
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. Electronic address: qianchn@sysucc.org.cn.
authors.forename: Chao-Nan
authors.initials: CN
authors.lastname: Qian
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D015984:Causality; D002681:China / Q000453:epidemiology; D003287:Contrast Media; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000401:mortality; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D015994:Incidence; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000401:mortality; D015588:Observer Variation; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Contrast-enhanced ultrasound; Hepatocellular carcinoma; Intra-tumor microvasculature density; Prognosis