MR Features Based on LI-RADS Ver. 2018 Correlated with Cytokeratin 19 Expression in Combined Hepatocellular Carcinoma-Cholangiocarcinoma

Changwu Zhou; Xiaoyan Ni; Xin Lu; Yi Wang; Xianling Qian; Chun Yang; Mengsu Zeng

doi:10.2147/JHC.S325686

MR Features Based on LI-RADS Ver. 2018 Correlated with Cytokeratin 19 Expression in Combined Hepatocellular Carcinoma-Cholangiocarcinoma

J Hepatocell Carcinoma. 2021 Aug 21:8:975-983. doi: 10.2147/JHC.S325686. eCollection 2021.

Authors

Changwu Zhou^#^{1

2}, Xiaoyan Ni^#², Xin Lu², Yi Wang², Xianling Qian², Chun Yang², Mengsu Zeng^{1

2}

Affiliations

¹ Shanghai Institute of Medical Imaging, Shanghai, People's Republic of China.
² Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: To investigate the significance of MR features based on the Liver Imaging Reporting and Data System (LI-RADS ver. 2018) for identifying the expression of cytokeratin 19 (CK-19) in patients with combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA) before surgery.

Patients and methods: The study enrolled 174 patients pathologically confirmed to have cHCC-CCA according to the 2019 WHO classification. The preoperative MR imaging features and clinicopathological findings were retrospectively evaluated and compared between the CK-19-positive and CK-19-negative cHCC-CCA groups.

Results: One hundred seventy-four patients (mean age, males vs females: 56.6 ± 10.0 years vs 54.7 ± 14.2 years) were evaluated. The presence of mosaic architecture, targetoid appearance, cholangiectasis, hepatic capsule retraction, and corona enhancement was significantly higher in the CK-19-positive group (all p < 0.05), while nonrim arterial phase hyperenhancement (APHE) was more common in the CK-19-negative group (p = 0.04). The univariate analysis showed that hepatitis B virus infection, CEA > 5 ng/mL, tumor size, nonrim APHE, mosaic architecture, targetoid appearance, cholangiectasis, hepatic capsule retraction, and corona enhancement were significant risk factors for CK-19-positive cHCC-CCA (all p < 0.05). Unfortunately, the multivariate analysis revealed that only corona enhancement (OR = 2.359, p = 0.03) was an independent risk factor associated with CK-19-positive cHCC-CCA.

Conclusion: Corona enhancement is significantly correlated with CK-19 positivity in patients with cHCC-CCA.

Keywords: cytokeratin 19; liver neoplasms; magnetic resonance imaging.

Grants and funding

This study has received funding by National Natural Science Foundation of China (grant number 91859107), Shanghai Science and Technology Committee (grant number 18DZ1930102), Shanghai Science and Technology Committee (grant number 19411965500), Zhongshan Hospital, Fudan University (grant number 2018ZSLC22), Shanghai Municipal Key Clinical Specialty (grant number shslczdzk03202), Clinical Research Plan of SHDC (grant number SHDC2020CR1029B), and Zhongshan Hospital, Fudan University (grant number 2020ZSLC61).