Correlation of Preoperative Gd-EOB-DTPA-Contrast-Enhanced MRI With TGF-β1 Expression in Hepatocellular Carcinoma

doi:10.21203/rs.3.rs-468368/v1

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Correlation of Preoperative Gd-EOB-DTPA-Contrast-Enhanced MRI With TGF-β1 Expression in Hepatocellular Carcinoma

https://doi.org/10.21203/rs.3.rs-468368/v1

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Purpose: To investigate the feasibility of preoperative gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) -enhanced magnetic resonance imaging (MRI) related signs in predicting transforming growth factor-β1(TGF-β1) gene expression in hepatocellular carcinoma (HCC).

Materials and methods: Sixty patients with HCC (55 males, mean age 52.6±12 years) who underwent preoperative MRI enhancement were retrospectively analyzed. Qualitative and quantitative features of Gd-EOBDTPA-enhanced MRI in these pathologically confirmed HCC patients were analyzed. Reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC) were performed to determine the mRNA and protein levels of TGF-β1 in HCC. The relationship between these imaging features and TGF-β1 expression level in HCC was evaluated by rank sum test, correlation analysis and logistic regression analysis.

Results: RT-PCR indicated that the expression level of TGF-β1 mRNA was statistically significant with the change of hepatobiliary signal (P=0.009). Immunohistochemical results indicated that the apparent diffusion coefficient (ADC) value of tumor was statistically significant at the protein level (P=0.038).There was no statistical significance in the distribution of other image features. Binary logistic regression analysis suggested that heterogeneous signals in hepatobiliary phase were independent risk factors for high TGF-β1 expression in HCC (P=0.012,OR=5.333,95%CI:1.437-19.801). Multivariate logistic regression analysis showed that ADC value was not an independent risk factor for TGF-β1 expression.

Conclusions: heterogeneous signal performance in the hepatobiliary phase and/or ADC values of HCC are potential indicators of high expression of TGF-β1. Gd-EOB-DTPA-enhanced MRI may be useful in the selection of targeted therapies for patients with HCC.

Cancer Biology

Hepatocellular carcinoma

magnetic resonance imaging (MRI)

Gd-EOB-DTPA-enhanced MRI

TGF-β1

targeted cancer therapy

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Table1 Comparison between qualitative magnetic resonance imaging(MRI) features and gene TGF-β1 expression of HCC with immunohistochemical

MRI features (60 cases)	TGF-β1
	c2	p value
Tumor thrombus
Ye s n=(5)	0.400	0.819
None n=(55)
T2WI Signal intensity	2.182	0.336
homogeneous n=(4)
heterogeneous n=(56)
hepatobiliary phase Signal	0.524	0.769
hypointensity n=(44)
heterogeneous n=(16)
Tumor capsule	1.522	0.467
Complete n=(29)
Incomplete n=(13)
None n=(18)
Tumor margins	1.539	0.463
Smooth solitary nodule n=(24)
Protruding nodule n=(24)
Fusion of multiple nodules n=(11)
infiltrative n=(1)
Intratumoral vascular	0.403	0.817
Ye s n=(22)
None n=(38)
Intratumoral hemorrhage	0.123	0.942
Yes n=(23)
None n=(37)
Fat in tumors	2.642	0.267
Yes n=(4)
None n=(56)

Table 2 Correlation between quantitative MRI features and TGF-β1 expression about immunohistochemical

MRI features	TGF-β1
	Correlation	p value
	coefficient
M a x i m u m d i a m e t e r ( m m ) (n= 60)	0.047	0.719
ADC (× 10^-3mm2/s) (n= 60)	-0.269	0.038
T1D%(n=22)	-0.060	0.789

Table 3 Comparison between qualitative Gd-EOB-DTPA enhanced MRI features and TGF-β1 mRNA expression level in HCC

MRI features (54 cases)	TGF-β1
	c2	p value
Tumor thrombus
Yes n=(8)	0.004	0.949
No n=(46)
T2WI Signal intensity	1.484	0.223
homogeneous n=(4)
heterogeneous n=(50)
hepatobiliary phase Signal	6.735	0.009
hypointense n=(38)
heterogeneous n=(16)
Tumor capsule	0.000	0.983
Complete n=(18)
Incomplete n=(11)
None n=(25)
Tumor margins	1.285	0.257
Smooth solitary nodule n=(21)
Protruding nodule n=(22)
Fusion of multiple nodules n=(10)
infiltrative n=(1)
Intratumoral vascular	1.183	0.277
Yes n=(36)
No n=(18)
Intratumoral hemorrhage	0.570	0.450
Yes n=(20)
No n=(34)
Intratumoral fat	0.002	0.965
Yes n=(4)
No n=(50)

Table 4 Correlation between quantitative MRI features and TGF-β1 mRNA expression level in HCC

MRI features	TGF-β
	Correlation	p value
	coefficient
M a x i m u m d i a m e t e r ( m m ) (n= 60)	0.094	0.501
ADC (× 10^-3mm²/s) (n= 60)	-0.169	0.221
T1D%(n=19)	0.145	0.554

Table 5 Logistic regression analysis of signal performance in the hepatobiliary phase associated with TGF-β1 mRNA expression levels in HCC

Variables	p value	OR	95% CI
Hepatobiliary phase Signal	0.001
Heterogeneous vs hypointense (n=16/38)	0.012	5.333	1.437，19.801

No competing interests reported.

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Correlation of Preoperative Gd-EOB-DTPA-Contrast-Enhanced MRI With TGF-β1 Expression in Hepatocellular Carcinoma

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