本研究旨在明确计算机断层扫描（CT）上肝实质增强的异质性对肝细胞癌（HCC）患者肝切除后生存的影响。回顾性审查了 HCC 患者和接受肝切除术的患者的病历。采用三种不同增强CT扫描图像的标准差（SD）来估计肝实质强化的不均匀性：SD>5.6，不均匀强化；SD≤5.6，均匀强化。共有57名患者出现不均匀强化，143名患者出现均匀强化。异质增强的患者比其他增强的患者有更长的无病生存期和总生存期（对数秩检验，P < 0.001 和 P = 0.036）。病理检查显示瘤周肝组织不均匀强化，易出现间隔。有间隔肝组织中CD8细胞的阳性率显着高于无间隔肝组织（0.83% vs. 0.26%，P < 0.001）。有隔膜的肝组织中瘤周 CD8/Foxp3 比值高于无隔膜的肝组织（1.22 vs. 0.47，P = 0.001），且 CD8/Foxp3 > 0.8 的患者总生存期优于 CD8/Foxp3 ≤ 的患者0.8（对数秩检验，P = 0.028）。总之，接受肝切除且肝实质增强异质性的患者往往会出现肝间隔，这与较高的 CD8/Foxp3 比率和较长的生存期相关。因此，对比增强 CT 扫描可能是预测 HCC 结果的有用工具。AJCR 版权所有 © 2024。

This study aimed to define the role of heterogeneity of liver parenchymal enhancement on computed tomography (CT) in the survival of patients with hepatocellular carcinoma (HCC) after hepatic resection. The medical records of patients with HCCs and who had undergone hepatic resection were retrospectively reviewed. The standard deviation (SD) of three different enhanced CT scan images was used to estimate the heterogeneity of liver parenchymal enhancement: SD of > 5.6, heterogenous enhancement, and SD of ≤ 5.6, homogeneous enhancement. A total of 57 patients had heterogenous enhancement, and 143 patients had homogeneous enhancement. The patients with heterogenous enhancement had longer disease-free and overall survivals than those with other enhancements (log-rank test, P < 0.001 and P = 0.036). The pathologic exam showed that heterogenous enhancement tended to develop septa in the peritumoral liver tissues. The prevalence of CD8+ cells was significantly higher in the peritumor liver tissues with septa than in those without (0.83% vs. 0.26%, P < 0.001). The peritumoral CD8/Foxp3 ratio was higher in the liver tissues with septa than in those without (1.22 vs. 0.47, P = 0.001), and patients with CD8/Foxp3 of > 0.8 had better overall survival than those with CD8/Foxp3 of ≤ 0.8 (log-rank test, P = 0.028). In conclusion, patients who had undergone hepatic resection with a heterogenous liver parenchymal enhancement tended to develop hepatic septa, which was associated with a higher CD8/Foxp3 ratio and longer survival. Therefore, contrast-enhanced CT scans might be a useful tool to predict the outcome of HCC.AJCR Copyright © 2024.