Objective:The aim of this study was to assess the effectiveness of combining gadox-etic acid-enhanced magnetic resonance imaging with vessels encapsulating tumor clusters(VETC)in predicting early recurrence of hepatocellular carcinoma(HCC)after surgery.Methods:We conducted a retrospective analysis from January 2013 to January 2022 at the Third People's Hospital of Nantong,wherein 234 patients with hepatocellular carcinoma(HCC)diagnosed by pathology and immunohisto-chemistry after hepatectomy were identified.We recorded preoperative laboratory-related examination indicators,pathological findings,and imaging features of all enrolled patients.Of these,90 patients ex-perienced early recurrence,and the remaining 144 patients did not exhibit early recurrence.We recor-ded the preoperative laboratory-related examination indicators,VETC status,and imaging features of all enrolled patients.We analyzed the data using univariate and multivariate COX regression analysis to identify risk factors for predicting early postoperative recurrence of HCC with preoperative imaging factors combined with VETC and only preoperative imaging factors.We established a risk index based on the regression coefficient(β)for each risk factor.We used the Hosmer Lemeshow goodness of fit test to assess the consistency between the risk-scoring model predicted early recurrence status and the true early recurrence status.Furthermore,we plotted a receiver operating characteristic(ROC)curve to verify the diagnostic efficiency of the models.Results:The multivariate COX regression analysis of preoperative MRI combined with VETC status to predict early recurrence of HCC revealed that VETC(HR:2.385;95％CI:1.518-3.746),tumor diameter(HR:1.089;95％CI:1.003～1.183),and nonrim arterial phase hyperenhancement(HR:1.978;95％CI:1.265～3.093)were significant independent risk factors.In comparison,the multivariate COX regression analysis of only preoperative MRI high-lighted that tumor diameter(HR:1.012;95％CI:1.001～1.284),nonrim arterial phase hyperenhance-ment(HR:2.032;95％CI:1.2 92～3.198),and necrosis or severe ischemia(HR:1.530;95％CI:1.339～1.828)were independent risk factors for early recurrence of HCC.We developed two risk scoring models:the risk scoring model(with VETC)and the risk scoring model(without VETC).The Hos-mer-Lemeshow goodness of fit test revealed that both models predicted early recurrence of HCC with good consistency(risk score model(with VETC)x2=4.964,P=0.761;risk score model(without VETC)x2=4.776,P=0.092).The areas under curves for the two models were AUC with VETC=0.801 and AUC without VETC=0.747(Z=2.783,P=0.025).The optimal cutoff value for the risk score model with VETC was cutoff with VETC=7 while that for the risk score model without VETC was cutoff without VETC=5.Patients with risk scores ≥cutoff are at a high risk of early recurrence after surgery.Conclusion:The imaging features such as tumor diameter,nonrim arterial phase hyperen-hancement,and VETC status are significant independent risk factors for early recurrence after hepato-cellular carcinoma(HCC)surgery.The risk score model for predicting early recurrence after HCC sur-gery,constructed based on these factors,has better diagnostic efficacy than the risk score model built solely on preoperative imaging features.
维普
万方数据