Diagnostic value of contrast-enhanced CT in differentiating gallbladder carcinoma invading the liver from liver cancer involving gallbladder lesions

Abstract:

Objective To investigate the value of contrast-enhanced computer tomography（CT） in differential diagnosis between gallbladder carcinoma invading the liver and liver cancer involving gallbladder lesions.Methods The clinical and imaging data of 115 patients in our hospital from February 2012 to February 2022 were collected，including 69 cases of gallbladder cancer invading the liver and 46 cases of liver cancer involving the gallbladder. A total of 13 observation indexes were recorded and statistically analyzed，including their gender，age，tumor size，tumor borders，gallbladder morphology，liver cirrhosis， bile duct dilation，high-density shadow in tumor or bile duct system，portal vein tumor thrombus， enhancement mode，degree of intensification，enhancement mode，and distant metastasis.Results There was statistical significance in observation indexes，including gender（P=0.007），age（P=0.002），tumor size（P=0.003），liver cirrhosis（P<0.001），high-density shadow in tumor or bile duct system（P=0.013），portal vein tumor thrombus（P<0.001），enhancement mode（P<0.001） and lymph node enlargement（P=0.034）. Based on bivariate logistic regression analysis，four observation indexes were selected to be significant classification indicators，including age（sensitivity：0.812；specificity：0.457），tumor size（sensitivity：0.630；specificity：0.696），portal vein tumor thrombus（sensitivity：0.326；specificity：0.957） and lymph node enlargement（sensitivity：0.681；specificity：0.522）. The AUC of combined differentiation of four observation was 0.770，with a sensitivity of 0.674 and a specificity of 0.826.Conclusion When contrast-enhanced CT differentiates gallbladder carcinoma invading the liver from liver cancer involving gallbladder lesions，gender，age，tumor size，liver cirrhosis，high-density shadow in tumor or bile duct system，portal vein tumor thrombus，enhancement mode and lymph node enlargement are helpful for differential diagnosis. Meanwhile，combining with age，tumor size，portal vein tumor thrombus and lymph node enlargement is helpful to improve the ability of differential diagnosis.