title: Predictive value of quantitative contrast-enhanced ultrasound in hepatocellular carcinoma recurrence after ablation.
abstract: OBJECTIVE
  To investigate the relationship between contrast-enhanced ultrasound (CEUS), basic fibroblast growth factor (bFGF), endothelin-1 (ET-1), and hepatocellular carcinoma (HCC) recurrence after ablation.
  
  
  METHODS
  A total of 51 HCC patients (38 males and 13 females) who received radiofrequency ablation in our hospital from June 2012 to July 2014 were enrolled in this study. The patients were divided into two groups: recurrence group and non-recurrence group. Routine abdominal examination was first performed in the horizontal position. Then the patients underwent CEUS and immunohistochemical staining before receiving radiofrequency ablation. All patients were followed-up every three months for one year. The results of CEUS and serum tumor marker levels were evaluated and combined together to estimate HCC recurrence and metastasis. Patients were divided into two groups: recurrence group and non-recurrence group. Quantitative parameters of CEUS and tumor expression levels of bFGF and ET-1 were compared between the two groups, respectively. Binary logistic regression analysis was used to analyze the relationship between CEUS quantitative parameters, expression levels of ET-1 and bFGF, and HCC recurrence after ablation.
  
  
  RESULTS
  Based on the quantitative parameters of CEUS before patients received radiofrequency ablation, the levels of tumor rise time (tRT), tumor time to peak (tTTP), tumor peak intensity (tPI) and tumor-parenchymal peak intensity (t-pPI) in the recurrence group were significantly lower than those in the non-recurrence group (16.6 ± 6.1 vs 23.2 ± 7.0, P = 0.000; 41.2 ± 10.2 vs 59.6 ± 14.2, P = 0.000; 23.8 ± 6.7 vs 31.4 ± 6.4, P = 0.000; 7.1 ± 3.4 vs 14.6 ± 7.4, P = 0.000; respectively). The expression levels of bFGF in the recurrence group were significantly higher than those in the non-recurrence group (P < 0.05). Levels of tTTP showed a significant inverse correlation with the level of bFGF in tumors (r = -0.312, P = 0.037). The Binary logistic regression analysis results revealed that the levels of tRT, tTTP, tPI and the level of bFGF were associated with HCC recurrence after radiofrequency ablation (P < 0.05).
  
  
  CONCLUSIONS
  CEUS is a noninvasive and effective method for evaluating the angiogenesis of HCC, and predicting its recurrence and prognosis.
authors.affiliation: Yi Gao, Zheng Cui, Yan Ma, Department of Ultrasound in Medicine, Tongji University Affiliated East Hospital, Shanghai 200120, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Yi Gao, Zheng Cui, Yan Ma, Department of Ultrasound in Medicine, Tongji University Affiliated East Hospital, Shanghai 200120, China.
authors.forename: Dong-Yan
authors.initials: DY
authors.lastname: Zheng
authors.affiliation: Yi Gao, Zheng Cui, Yan Ma, Department of Ultrasound in Medicine, Tongji University Affiliated East Hospital, Shanghai 200120, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Cui
authors.affiliation: Yi Gao, Zheng Cui, Yan Ma, Department of Ultrasound in Medicine, Tongji University Affiliated East Hospital, Shanghai 200120, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Yi Gao, Zheng Cui, Yan Ma, Department of Ultrasound in Medicine, Tongji University Affiliated East Hospital, Shanghai 200120, China.
authors.forename: Yuan-Zhi
authors.initials: YZ
authors.lastname: Liu
authors.affiliation: Yi Gao, Zheng Cui, Yan Ma, Department of Ultrasound in Medicine, Tongji University Affiliated East Hospital, Shanghai 200120, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation; D003287:Contrast Media; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000097:blood / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010743:Phospholipids; D011237:Predictive Value of Tests; D012307:Risk Factors; D013459:Sulfur Hexafluoride; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D014408:Biomarkers, Tumor; D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: Contrast-enhanced ultrasonography; Hepatocellular carcinoma; Radiofrequency ablation