Comparative Study On The Imaging Data Of Primary Liver Cancer With Negative Alpha-fetoprotein

Objective：To discuss the imaging and clinical features of primary liver cancer (PLC) with negative alpha-fetoprotein (AFP), and evaluate the diagnostic value of CT, MR and US.Methods：At Zhongshan Hospital of Xiamen University from Sep.2010to Sep.2013,231patients with PLC were confirmed by surgery and pathology, of which99cases were negative AFP,132cases were positive AFP.The histological type, the incidence of gender, age, disease location and imaging performance were retrospectively analyzed, and comparisons were done using the statistical software of SPSS.Result：1、Pathological type of PLC with negative AFP: In the99cases, there are78cases (78.8%) with hepatocellular carcinoma (HCC),20cases (20.2%) with intrahepatic cholangiocarcinoma (ICC),1case (1.0%) with mixed cell carcinoma (MCC). Compared with group of positive AFP, there are significant differences in the distribution of HCC, ICC (P <0.05).2、AFP negative PLC clinical and CT imaging features:①Clinical features: There were78HCC patients. Among them,43(55.1%) were found by physical examination,20(25.6%) by abdominal pain. Compared with the data of AFP-positive HCC131patients，there are significant differences (P <0.05). There were20ICC patients,12males (60%) and8females (40%). Among them,3(15.0%) cases were found by examination,11(55.0%) by abdominal pain, and9(45.0%)by jaundice. Compared with the data of78AFP-negative HCC patients, there are significant differences (P <0.05).②Imaging features：There were53HCC patients with CT images.20(37.7%) of them displayed tumor size≤3cm,3(5.7%) of them merge with liver cirrhosis and2(3.8%) merge with portal vein tumor thrombus. Compared with the data of71case of AFP-positive HCC, there are significant differences (P <0.05). There8ICC patients with CT images.7(87.5%) of them showed progressive strengthening and7(87.5%) of them merge with intrahepatic bile duct dilatation, Compared with the data of53AFP-negative HCC cases, there are significant differences (P <0.05).3、AFP-negative PLC Imaging comparison: The diagnosis rates of AFP-negative HCC patients confirmed by CT, MRI and B-ultrasound were50.9%(27/53),50%(6/12),10.4%(5/49) respectively. The ICC patients confirmed by MRI, CT and B-ultrasound were6patients (6/11),2cases (2/8),0cases (0/12) respectively. There are significant difference (P <0.05) between the groups.Conclusion：1、HCC with negative AFP are the enhanced mode of fast-in or slow-in and faster-out,which are similar with that of HCC with positive AFP，then the size of tumors are smaller，fewer with liver cirrhosis and portal involvement when examiated with the imaging. ICC with negative AFP are the enhanced mode of progressive strengthening，have more multiple intrahepatic bile duct dilatation than HCC with negative AFP. The accuracy of CT, MRI diagnosing the HCC with negative AFP are higher than US，MRI diagnosting the ICC is highest.2、Clinical manifestations of patients with negative AFP HCC are lighter than the positive，abdominal pain and jaundice of patients with negative AFP ICC are more than the HCC.