Preoperative color Doppler ultrasonography predicts early recurrence in AFP-positive hepatocellular carcinoma

Miao Chen; Duo Wang; Yuan Zhao; Dan-Mei Lu; Hong-Xue Li; Jun-Jie Liu; Hang Li

doi:10.3892/ol.2019.10825

Preoperative color Doppler ultrasonography predicts early recurrence in AFP-positive hepatocellular carcinoma

Oncol Lett. 2019 Nov;18(5):4703-4711. doi: 10.3892/ol.2019.10825. Epub 2019 Sep 9.

Authors

Miao Chen¹, Duo Wang¹, Yuan Zhao², Dan-Mei Lu³, Hong-Xue Li¹, Jun-Jie Liu¹, Hang Li¹

Affiliations

¹ Department of Ultrasound, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China.
² Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China.
³ Department of Ultrasound, The First People's Hospital of Nanning, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China.

Abstract

The present study aimed to evaluate the hepatic hemodynamics of patients with α-fetoprotein (AFP)-positive hepatocellular carcinoma (HCC) and early recurrence (ER), as determined by color Doppler ultrasound. Screening with color Doppler ultrasound was performed in 150 patients with AFP-positive HCC, yielding 43 cases with postoperative ER. In addition, 35 healthy controls were enrolled in the study for comparison of the blood flow parameters between the healthy control and the HCC groups. Receiver operating characteristic curve analysis was performed to evaluate the predicted effect of Doppler for the ER of HCC. The average mean flow velocity of portal vein in patients with HCC (14.686±5.873 cm/s) was significantly lower in the HCC group compared with the healthy control group (17.631±3.569 cm/s; P=0.005). Additionally, the preoperative portal vein diameter in the HCC group was significantly higher compared with that in the healthy control group (P=0.001). Regarding the effect of surgery, the portal vein diameter was significantly increased in the patients postoperatively compared with preoperatively (P=0.003), while the pulsation and resistance indexes exhibited a decreasing trend in the postoperative group (P=0.001 and P=0.003, respectively). Notably, patients with HCC and ER presented with a higher resistance index (1.163±0.342) compared with the ER-free group (1.023±0.176; P=0.004). Furthermore, a significant difference in hepatic artery pulsation index was also observed between the ER group (0.673±0.075) and the ER-free group (0.624±0.056; P=0.018), indicating that an increased hepatic artery pulsation index may significantly predict the ER of HCC. In addition, areas under the curve of 0.683 and 0.700, respectively, suggested that the hepatic artery resistance and pulsation indexes may be used to diagnose ER in HCC (P=0.009 and P=0.004, respectively). Taken together, Doppler ultrasound provides a reliable and accurate quantification of hepatic hemodynamics for detecting ER in HCC with a good diagnostic accuracy.

Keywords: color Doppler ultrasound; early recurrence; hepatic hemodynamics; hepatocellular carcinoma.