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目的探讨AFP异质体阳性(AFP-L3/AFP≥10%)肝癌的超声及超声造影特点,为AFP异质体阳性肝癌患者预后差提供超声影像学依据。方法随机选择AFP异质体阳性肝癌57例(阳性组)和AFP异质体阴性肝癌30例(阴性组),对比分析2组的超声及超声造影表现,并行统计学分析。结果阳性组病灶最大径≥5 cm 41例(71.9%),多发或弥漫阳性组34例(59.6%),边缘不清或不规则阳性组39例(68.4%),回声不均匀阳性组43例(75.4%),侵犯血管及肝内转移阳性组为31例(56.1%),均显著高于阴性组(P<0.05);病灶呈高回声30例(52.6%),高于阴性组10例(33.3%),而低回声12例(21.1%),低于阴性组12例(40.0%),但2组无统计学差异(P>0.05)。超声造影:阳性组23例表现为“快进快出”16例(69.6%),“快进慢出”7例(30.4%);而阴性组15例表现为“快进快出”5例(33.3%),“快进慢出”10例(66.7%),2组差异具有统计学意义(P<0.05)。结论AFP异质体阳性肝癌超声检查具有肿瘤体积大、浸润性生长、易侵犯血管和发生肝内转移,增强以“快进快出”为主的影像学特点,提示预后不良。
Objective To investigate the characteristics of ultrasound and contrast-enhanced ultrasound in the diagnosis of liver cancer with AFP-L3 / AFP≥10%, and provide the basis of ultrasound imaging for the poor prognosis of AFP-positive hepatocellular carcinoma. Methods 57 cases (positive group) of AFP heterogeneity-positive hepatocellular carcinoma and 30 cases of AFP negative-type hepatocellular carcinoma (negative group) were randomly selected. The ultrasound and contrast-enhanced ultrasound were compared between the two groups and statistically analyzed. Results In the positive group, 41 cases (71.9%) were found with the largest diameter of ≥5 cm, 34 cases (59.6%) with multiple or diffuse positive group, 39 cases (68.4%) with unclear margin or irregular positive group, and 43 cases with uneven echogenicity (75.4%), and 31 cases (56.1%) in the group of vascular invasion and intrahepatic metastasis were significantly higher than those in the negative group (P <0.05). Thirty patients (52.6% (33.3%), while 12 patients (21.1%) had hypoechoic lesion, which was lower than 12 patients (40.0%) in the negative group, but there was no significant difference between the two groups (P> 0.05). Contrast-enhanced ultrasound showed that in 23 cases of positive group, 16 cases (69.6%) were fast-forward fast-out and 7 cases (30.4%) were fast-forward slow- 5 cases (33.3%) were fasting out and 10 cases (66.7%) were fast moving in and out. The difference between the two groups was statistically significant (P <0.05). Conclusion Ultrasound examination of AFP heterozygous positive hepatocarcinoma has the characteristics of large tumor volume, invasive growth, easy invasion of blood vessels and intrahepatic metastasis, and enhancement of imaging features such as “fast forward fast”, suggesting a poor prognosis.