Study on microscopic marginal extensions of malignant liver tumors based on tumor types and ultrasonic characteristics

Abstract

Objective To study the relationships between microscopic marginal extensions and tumor types, and ultrasonic characteristics of malignant liver tumors. Methods Two-dimensional ultrasonography, contrast-enhanced ultrasonography and ultrasound-guided biopsy of hepatic tumors and surrounding hepatic tissues were performed in 78 patients with malignant liver tumor. Pathological microscopic extensions were observed after hematoxylin-eosin staining of biopsy specimens. Results The microscopic marginal extension rates of hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC) and metastatic liver cancer (MLC) were 62.5%(30/48), 87.5%(7/8), and 91.0% (20/22), respectively. For tumors with well-defined and poorly-defined two-dimensional ultrasound boundary, microscopic marginal extension rates were 50%(14/28), and 86%(43/50). Tumor type and two-dimensional ultrasound boundary were independent predictors for microscopic extension rate (P<0.05). The median microscopic extension distances of HCC, ICC and MLC were 1.0(0, 3.0)mm, 4.0(2.3, 4.0)mm, and 2.0(1.8, 4.0)mm, respectively. The distance of microscopic extension increased with tumor size. Tumor type and tumor size were independent predictors for the distance of microscopic extension (P<0.05). Conclusions ICC, MLC, and tumors with larger diameter or poorly-defined two-dimensional ultrasound boundary have a larger distance of microscopic extension. Key words: Ultrasonography; Contrast-enhanced ultrasonography; Liver tumors; Tumor micro-invasion