Diagnostic value of contrast-enhanced CT in differentiating gallbladder carcinoma invading the liver from liver cancer involving gallbladder lesions

Zhang Xinyu; Li Xinyi; Zheng Yunlin; Gao Jueni; Wen Ming

doi:10.13406/j.cnki.cyxb.003181

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Diagnostic value of contrast-enhanced CT in differentiating gallbladder carcinoma invading the liver from liver cancer involving gallbladder lesions

Clinical research | 更新时间：2023-04-13

- Diagnostic value of contrast-enhanced CT in differentiating gallbladder carcinoma invading the liver from liver cancer involving gallbladder lesions
- Journal of Chongqing Medical University Vol. 48, Issue 3, Pages: 286-290(2023)
- 作者机构：
  
  重庆医科大学附属第一医院放射科，重庆 400016
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003181
  CLC： R445.3
- Received：28 June 2022，
  
  Revised：2022-11-10，
  
  Accepted：02 December 2022，
  
  Published：28 March 2023
- 稿件说明：
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张新宇,李欣益,郑韵琳等.探讨增强CT在鉴别胆囊癌侵犯肝脏与肝癌累及胆囊病变中的应用价值[J].重庆医科大学学报,2023,48(03):286-290.

Zhang Xinyu,Li Xinyi,Zheng Yunlin,et al.Diagnostic value of contrast-enhanced CT in differentiating gallbladder carcinoma invading the liver from liver cancer involving gallbladder lesions[J].Journal of Chongqing Medical University,2023,48(03):286-290.
张新宇,李欣益,郑韵琳等.探讨增强CT在鉴别胆囊癌侵犯肝脏与肝癌累及胆囊病变中的应用价值[J].重庆医科大学学报,2023,48(03):286-290. DOI： 10.13406/j.cnki.cyxb.003181.

Zhang Xinyu,Li Xinyi,Zheng Yunlin,et al.Diagnostic value of contrast-enhanced CT in differentiating gallbladder carcinoma invading the liver from liver cancer involving gallbladder lesions[J].Journal of Chongqing Medical University,2023,48(03):286-290. DOI： 10.13406/j.cnki.cyxb.003181.

摘要

目的

探讨增强电子计算机断层扫描（computer tomography，CT）在胆囊癌侵犯肝脏与肝癌累及胆囊病变中的鉴别诊断价值。

方法

收集2012年2月到2022年2月重庆医科大学附属第一医院115例患者临床及影像学资料，其中胆囊癌侵犯肝脏病例69例，肝癌累及胆囊病例46例，记录性别、年龄、肿瘤大小、肿瘤边界、胆囊形态、肝硬化、胆管扩张、肿瘤内或胆管系统内高密度影、门静脉癌栓、强化方式、强化程度、淋巴结肿大及远处转移共13个观察指标，并进行统计学分析。

结果

性别（

=0.007）、年龄（

=0.002）、肿瘤大小（

=0.003）、肝硬化（

0.001）、肿瘤内或胆管系统内高密度影（

=0.013）、门静脉癌栓（

0.001）、强化方式（

0.001）及淋巴结肿大（

=0.034）有统计学差异。通过回归分析筛选出年龄（敏感度为0.812，特异度为0.457）、肿瘤大小（敏感度为0.630，特异度为0.696）、门静脉癌栓（敏感度为0.326，特异度为0.957）、淋巴结肿大（敏感度为0.681，特异度为0.522）为显著分类指标，联合4个观察指标的参数绘制受试者工作特征（receiver operating characteristic，ROC）曲线，曲线下面积（area under the curve，AUC）为0.770，敏感度为0.674，特异度为0.826。

结论

增强CT在鉴别胆囊癌侵犯肝脏与肝癌累及胆囊病变时，性别、年龄、肿瘤大小、肝硬化、肿瘤内或胆管系统内高密度影、门静脉癌栓、强化方式及淋巴结肿大有鉴别价值，同时结合年龄、肿瘤大小、门静脉癌栓及淋巴结肿大有助于提高鉴别诊断能力。

Abstract

Objective

To investigate the value of contrast-enhanced computer tomography（CT） in differential diagnosis between gallbladder carcinoma invading the liver and liver cancer involving gallbladder lesions.

Methods

The clinical and imaging data of 115 patients in our hospital from February 2012 to February 2022 were collected，including 69 cases of gallbladder cancer invading the liver and 46 cases of liver cancer involving the gallbladder. A total of 13 observation indexes were recorded and statistically analyzed，including their gender，age，tumor size，tumor borders，gallbladder morphology，liver cirrhosis， bile duct dilation，high-density shadow in tumor or bile duct system，portal vein tumor thrombus， enhancement mode，degree of intensification，enhancement mode，and distant metastasis.

Results

There was statistical significance in observation indexes，including gender（

0.007），age（

0.002），tumor size（

0.003），liver cirrhosis（

0.001），high-density shadow in tumor or bile duct system（

0.013），portal vein tumor thrombus（

0.001），enhancement mode（

0.001） and lymph node enlargement（

0.034）. Based on bivariate logistic regression analysis，four observation indexes were selected to be significant classification indicators，including age（sensitivity：0.812；specificity：0.457），tumor size（sensitivity：0.630；specificity：0.696），portal vein tumor thrombus（sensitivity：0.326；specificity：0.957） and lymph node enlargement（sensitivity：0.681；specificity：0.522）. The AUC of combined differentiation of four observation was 0.770，with a sensitivity of 0.674 and a specificity of 0.826.

Conclusion

When contrast-enhanced CT differentiates gallbladder carcinoma invading the liver from liver cancer involving gallbladder lesions，gender，age，tumor size，liver cirrhosis，high-density shadow in tumor or bile duct system，portal vein tumor thrombus，enhancement mode and lymph node enlargement are helpful for differential diagnosis. Meanwhile，combining with age，tumor size，portal vein tumor thrombus and lymph node enlargement is helpful to improve the ability of differential diagnosis.

关键词

Keywords

references

Cao W ， Chen HD ， Yu YW ， et al . Changing profiles of cancer burden worldwide and in China：a secondary analysis of the global cancer statistics 2020 [J]. Chin Med J（Engl）， 2021 ， 134 （ 7 ）： 783 - 791 .

Ganeshan D ， Kambadakone A ， Nikolaidis P ， et al . Current update on gallbladder carcinoma [J]. Abdom Radiol ， 2021 ， 46 （ 6 ）： 2474 - 2489 .

胡铭洋，吴绮楠，吴永忠 . 肝癌的靶向和免疫治疗 [J]. 重庆医科大学学报， 2019 ， 44 （ 12 ）： 1547 - 1552，1524 .

Hu MY ， Wu QN ， Wu YZ . Targeted and immune-based therapies for hepatocellular carcinoma [J]. J Chongqing Med Univ ， 2019 ， 44 （ 12 ）： 1547 - 1552，1524 .

Hickman L ， Contreras C . Gallbladder cancer：diagnosis，surgical management，and adjuvant therapies [J]. Surg Clin North Am ， 2019 ， 99 （ 2 ）： 337 - 355 .

Gunasekaran G ， Bekki Y ， Lourdusamy V ， et al . Surgical treatments of hepatobiliary cancers [J]. Hepatology ， 2021 ， 73 （ Suppl 1 ）： 128 - 136 .

郑韵琳，刘　欢，文明 . 基于多期CT影像组学模型及联合模型鉴别腮腺多形性腺瘤与基底细胞瘤 [J]. 中国医学影像学杂志， 2022 ， 30 （ 3 ）： 220 - 227 .

Zheng YL ， Liu H ， Wen M . Radiomics analysis based on multi-phase CT and combined model differentiated pleomorphic adenoma from basal cell adenoma [J]. Chin J Med Imaging ， 2022 ， 30 （ 3 ）： 220 - 227 .

张正芳，魏黎明，赵俊功 . 胆囊癌与貌似胆囊癌的CT征象差异分析 [J]. 临床放射学杂志， 2020 ， 39 （ 4 ）： 704 - 709 .

Zhang ZF ， Wei LM ， Zhao JG . Analysis on the difference of CT signs between gallbladder carcinoma and pseudo gallbladder carcinoma [J]. J Clin Radiol ， 2020 ， 39 （ 4 ）： 704 - 709 .

李艳玲，贾守强，翟艳慧，等 . 多排螺旋CT在肝脏及胆囊同时受侵病变鉴别诊断中的研究 [J]. 医学影像学杂志， 2018 ， 28 （ 1 ）： 83 - 86 .

Li YL ， Jia SQ ， Zhai YH ， et al . Clinical study of the value of MDCT in differential diagnosis of lesions invading both liver and gallbladder [J]. J Med Imaging ， 2018 ， 28 （ 1 ）： 83 - 86 .

Marks RM ， Masch WR ， Chernyak V . LI-RADS：past，present，and future，from the AJR special series on radiology reporting and data systems [J]. AJR Am J Roentgenol ， 2021 ， 216 （ 2 ）： 295 - 304 .

Liu PH ， Huo TI ， Miksad RA . Hepatocellular carcinoma with portal vein tumor involvement：best management strategies [J]. Semin Liver Dis ， 2018 ， 38 （ 3 ）： 242 - 251 .

Muszynska C ， Lundgren L ， Lindell G ， et al . Predictors of incidental gallbladder cancer in patients undergoing cholecystectomy for benign gallbladder disease：results from a population-based gallstone surgery registry [J]. Surgery ， 2017 ， 162 （ 2 ）： 256 - 263 .

Kuipers H ， Hoogwater FJH ， Holtman GA ， et al . Diagnostic performance of preoperative CT in differentiating between benign and malignant origin of suspicious gallbladder lesions [J]. Eur J Radiol ， 2021 ， 138 ： 109619 .

Oriakhi M ， Andrabi SA ， Olutoyin A ， et al . A rare presentation of hepatocellular carcinoma infiltrating the gallbladder [J]. Cureus ， 2019 ， 11 （ 7 ）： e5140 .

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