XXXX recurrence: Patterns and relation between vascularity and differentiation degree.

@entity1 @entity157 @entity5
AIM: To evaluate the relationship between @entity157 ( @entity157 ) vascularity and grade; to describe patterns and vascular/histopathological variations of post-transplantation recurrence. METHODS: This retrospective study included 165 @entity1 (143 @entity1 , 22 @entity1 ; median age 56.8 years, range 28-70.4 years) transplanted for @entity157 who had a follow-up period longer than 2 mo. Pre-transplantation dynamic computed tomography or magnetic resonance examinations were retrospectively reviewed, classifying @entity157 imaging enhancement pattern into hypervascular and hypovascular based on presence of wash-in during arterial phase. All pathologic reports of the explanted livers were reviewed, collecting data about @entity157 differentiation degree. The association between imaging vascular pattern and pathological grade was estimated using the Fisher exact test. All follow-up clinical and imaging data were reviewed for evidence of recurrence. Recurrence rate was calculated and imaging features of recurrent @entity5 were collected, classifying early and late recurrences based on timing (< or >=  2 years after transplantation) and intrahepatic, extrahepatic and both intrahepatic and extrahepatic recurrences based on location. All intrahepatic recurrences were classified as hypervascular or hypovascular and the differentiation degree was collected where available. The presence of variations in imaging enhancement pattern and pathological grade between the @entity5 and the intrahepatic recurrence was evaluated and the association between imaging and histopatholgical variations was estimated by using the   (2) test. RESULTS: Of the 163 @entity1 with imaging evidence of viable @entity5 , 156 (95.7%) had hypervascular and 7 (4.3%) @entity157 . Among the 125 @entity1 with evidence of viable @entity5 in the explanted liver, 19 (15.2%) had grade 1, 56 (44.8%) grade 2, 40 (32%) grade 3 and 4 (3.2%) grade 4 @entity157 , while the differentiation degree was not assessable for 6 @entity1 (4.8%). A significant association was found between imaging vascularity and pathological grade (P = 0.035). Post-transplantation recurrence rate was 14.55% (24/165). All recurrences occurred in @entity1 who had a hypervascular @entity5 . Three @entity1 (12.5%) experienced late recurrence; the location of the first recurrence was extrahepatic in 14 @entity1 (58.3%), intrahepatic in 7 @entity1 (29.2%) and both intrahepatic and extrahepatic in 3 @entity1 (12.5%). Two @entity1 had a variation in imaging characteristics between the primary @entity157 (hypervascular) and the intrahepatic recurrent @entity157 (hypovascular), while 1 @entity1 had a variation of histopathological characteristics (from moderate to poor differentiation), however no association was found between imaging and histopathological variations. CONCLUSION: A correlation was found between @entity157 grade and vascularity; some degree of variability may exist between the primary and the recurrence imaging/histopathological characteristics, apparently not correlated.
