Relationship between quantitative contrast-enhanced ultrasonography parameters and angiogenesis in primary small hepatocellular carcinoma

Abstract

To analyze the correlation between quantitative contrast-enhanced ultrasonography (CEUS) parameters and angiogenesis in primary small hepatocellular carcinoma (sHCC) with varying degrees of differentiation. According to varying degrees of differentiation, a total of 90 primary sHCC patients admitted to our hospital from July 2018 to January 2020 were selected and divided into poorly differentiated group (24 cases), moderately differentiated group (31 cases), and highly differentiated group (35 cases). All patients received real-time CEUS before surgery. The tumor diameter, microvascular morphology, grading of color blood flow, contrast-enhanced performance in different phases, quantitative CEUS parameters, expression of angiogenesis-related genes, and microvessel density (MVD) were compared among the 3 groups. The correlation between quantitative parameters of CEUS and angiogenesis indexes was analyzed by Spearman rank correlation analysis. Spearman rank correlation analysis showed that vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), epidermal growth factor receptor (EGFR), and angiopoietin-2 (Ang-2) expression and MVD were negatively correlated with the time to peak (TTP), wash-out time, and peak accelerating time (PAT) ( r < 0, P < .05), and were positively correlated with enhancing slope rate (ESR) and peak intensity increasing rate (PIIR) ( r > 0, P < .05). CEUS is able to identify varying degrees of differentiation in primary sHCC, and the quantitative CEUS parameters are closely related to angiogenesis.

Contrast-enhanced ultrasonography for differential diagnosis of adnexal masses

“…The tumor vasculature exhibits atypical morphological features and is characterized by dilated, tortuous disorganized blood vessels, arteriovenous fistula, and incomplete muscularization of vessel walls. This results in lower resistance to flow, few systolicdiastolic variations in blood flow velocity, and shorter washout time compared with that in normal vessels (27,28,33).…”

Multimodal Imaging under Artificial Intelligence Algorithm for the Diagnosis of Liver Cancer and Its Relationship with Expressions of EZH2 and p57

“…In poorly differentiated cancer tissues, the intercellular bridge is not clear, and the nuclear atypia is obvious, while the cell tissue necrosis exists in nuclear division, which leads to the adhesion of surrounding tissues, reducing their activity and tissue elasticity, and increasing their hardness [ 34 ]. Deng et al [ 35 ] proposed that vascular density in cancer foci is closely related to the degree of tissue differentiation in cancer foci, and patients with a lower degree of differentiation have higher blood flow grade. It is consistent with the results of this study, which indicates that there are differences in the ultrasound signs of small liver cancer tissues with different pathological grades, and ultrasound examination can be used for the diagnosis of pathological grades.…”

Contrast-enhanced ultrasound demonstrates greater adjuvant potential: past, current status, and future applications in Hepatocellular carcinoma early diagnosis

“…A small number of studies have investigated the correlation between ultrasound or CUES and the expression of other tumor markers such as glypican-3, cytokeratin 19 (CK19), and epidermal growth factor receptor (EGFR), although current studies have affirmed that these parameters are associated with tumor progression and poor prognosis in HCC [45][46][47]. EGFR may be negatively correlated with microvessel density, peak time, and washout time exhibited by CEUS [48]. Quantitative parameters of CEUS reflect tumor differentiation to some extent, and during HCC dedifferentiation, reduced normal blood supply to the liver and tumor neovascularization leads to tumor proliferation, thereby decreasing the expression of tumor suppressors [49].…”