Abstract:

Objective   To examine the relationship between clinical-pathological features and metabolic status of hepatocellular carcinoma (HCC) using in vivo 31P magnetic resonance spectroscopy (31P-MRS). Methods   31P-MRS scanning with a single voxel was carried out on 32 HCC lesions. Groups were formed for the following: with and without capsula, with and without cirrhosis, and with and without infiltration (intrahepatic daughter foci, tumor-emboli in portal veins and lymphatic metastasis). Another group was formed according to the pathological grades of the lesions. Intracellular pH value (pHi), and metabolic parameters including phosphomonoester (PME), phosphodiester (PDE), inorganic phosphate (Pi), γ-ATP, β-ATP, α-ATP, lower energetic phosphate (LEP), and the ratios PME/ATP, Pi/ATP, PME/PDE, PME/Pi, PDE/Pi and PDE/ATP were calculated. Differences in the metabolic parameters between different groups were analyzed. Results   HCC exhibited higher values for pHi, Pi, Pi/ATP and LEP, but lower values for α-ATP and PDE/Pi, than the liver (P<0.05). Lesions with capsula had higher β-ATP than those without (t=2.290, P=0.029). Lesions with cirrhosis had higher pHi and lower γ-ATP than those without (P<0.05). Lesions with infiltration had higher PME and PME/ATP than those without (P<0.05). Differences in Pi, Pi/ATP, PME/Pi and PDE/Pi of HCC among the three pathological grades were also identified statistically (P<0.05). These groups didnot show statistically significant differences for other metabolic parameters(P>0.05). Conclusion   Some phosphorus metabolites in HCC are related to clinical-pathological features, and 31P-MRS can be used to evaluate the biological behavior of HCC in a noninvasive fashion.

Key words: Carcinoma, hepatocellular; Magnetic resonance spectrum; Pathological feature