The value of quantitative CT body composition analysis in prediction of prognosis in patients with hepatic cell carcinoma treated with transcatheter arterial chemoembolization / 中华放射学杂志

ABSTRACT

Objective:To investigate the value of quantitative CT (QCT) body component parameters before and after transcatheter arterial chemoembolization (TACE) as prognostic indicator for patients with hepatic cell carcinoma (HCC).Methods:Retrospective analysis was performed on 40 patients with advanced HCC who received TACE treatment in Anhui Provincial Hospital Affiliated to Anhui Medical University from November 2013 to May 2017, all of them received QCT scanning before and after treatment. The information were recorded, including gender, age, alpha-fetoprotein (AFP), TNM stage, liver function Child-Pugh grade, portal venous thromboembolism, cirrhosis, maximum tumor diameter, tumor type, and frequency of interventional therapy. QCT parameters were measured before and after treatment, including L1, L2 bone mineral density (BMD), L3-level paravertebral muscle area (MA), subcutaneous fat area (SFA) and visceral fat area (VFA), and the change rate of QCT parameters (&Delta;BMD, &Delta;MA, &Delta;SFA, &Delta;VFA) before and after TACE were calculated after the QCT scan interval was standardized. The cut-off values of &Delta;BMD, &Delta;MA, &Delta;SFA and &Delta;VFA to diagnose the prognosis of HCC patients after TACE were obtained by drawing the ROC curves. The Kaplan-Meier method was used to calculate the survival rate, the Log-rank method was used for univariate analysis, and the Cox regression analysis model was used for multivariate analysis to screen out independent factors affecting the prognosis of HCC patients after TACE.Results:ROC curve analysis showed that the cut-off values of &Delta;BMD, &Delta;MA, &Delta;SFA and &Delta;VFA to diagnose the prognosis of HCC patients after TACE were -8.64%, -6.84%, -9.84% and 5.70%, respectively. Univariate analysis showed that AFP, TNM stage, liver function Child-Pugh grade, portal venous thrombosis, tumor type and &Delta;MA, &Delta;SFA, &Delta;VFA had statistically significant effects on prognosis ( P<0.1). Multivariate analysis showed that &Delta;MA, &Delta;VFA and portal venous thromboembolism were independent influencing factors for the prognosis of HCC patients after TACE treatment ( P<0.05). Conclusions:&Delta;MA, &Delta;VFA and portal venous thromboembolism have reference value for prognosis assessment of TACE treatment for HCC patients, and QCT body composition analysis is helpful to evaluate the prognosis of HCC patients.