| 林如君,杨晓岑,李琪虹,陈丽旋,陈晓丽,刘 兵,温志坚.超声造影联合血清AFP、GGT与GLR对肝细胞癌微血管侵犯的预测价值[J].,2024,(13):2467-2472 |
| 超声造影联合血清AFP、GGT与GLR对肝细胞癌微血管侵犯的预测价值 |
| Predictive Value of Contrast-Enhanced Ultrasound Combined with Serum AFP, GGT and GLR for Microvascular Invasion of Hepatocellular Carcinoma |
| 投稿时间：2024-01-27 修订日期：2024-02-22 |
| DOI：10.13241/j.cnki.pmb.2024.13.012 |
| 中文关键词: 肝细胞癌 超声造影 甲胎蛋白 γ-谷氨酰转肽酶 淋巴细胞计数比值 微血管侵犯 |
| 英文关键词: Hepatocellular carcinoma Contrast-enhanced ultrasound Alpha-fetoprotein γ-glutamyl transpeptidase Lymphocyte count ratio Microvascular invasion |
| 基金项目:福建省自然科学基金项目（2018J05247）；厦门市医疗卫生指导性项目（3502Z20214ZD1187） |
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| 中文摘要: |
| 摘要 目的：分析超声造影（CEUS）联合血清甲胎蛋白（AFP）、γ-谷氨酰转肽酶（GGT）、淋巴细胞计数比值（GLR）对肝细胞癌（HCC）微血管侵犯（MVI）的预测价值。方法：选择2018年10月至2023年10月中国人民解放军陆军第七十三集团军医院行肝切除手术治疗的177例HCC患者，患者均于术前1周行CEUS及血清AFP、GGT、GLR检查。根据术后病理检查MVI结果，将患者分为MVI阳性组（n=52）与MVI阴性组（n=125）。采用多因素Logistic回归分析影响HCC患者MVI的危险因素，受试者工作特征（ROC）曲线分析CEUS联合AFP、GGT、GLR对HCC患者MVI的预测价值。结果：MVI阳性组始增时间、达峰时间、廓清时间短于MVI阴性组（P＜0.05）。MVI阳性组AFP、GGT和GLR明显高于MVI阴性组（P＜0.05）。多因素Logistic回归分析显示AFP升高、GGT升高、GLR升高、病灶形态不规则、始增时间缩短、达峰时间缩短、廓清时间缩短为HCC患者MVI的独立危险因素（P<0.001）。ROC结果显示：始增时间缩短、达峰时间缩短、廓清时间缩短联合血清AFP、GGT与GLR预测HCC患者MVI的曲线下面积为0.901，明显大于单独检测（P＜0.05）。结论：HCC术后MVI患者血清AFP、GGT、GLR升高，始增时间、达峰时间、廓清时间缩短，且为HCC患者MVI的独立危险因素。CEUS联合AFP、GGT、GLR对HCC患者MVI的预测价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the predictive value of contrast-enhanced ultrasound (CEUS) combined with serum alpha-fetoprotein (AFP), γ-glutamyl transpeptidase (GGT) and lymphocyte count ratio (GLR) for microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods: 177 HCC patients who underwent hepatectomy in The 73rd Group Army Hospital of the Chinese People's Liberation Army from October 2018 to October 2023 were selected, all patients underwent CEUS and serum AFP, GGT and GLR examinations 1 week before operation. According to the results of postoperative pathological examination of MVI, patients were divided into MVI positive group (n=52) and MVI negative group (n=125). The risk factors affecting MVI in HCC patients were analyzed by multivariate Logistic regression analysis, the predictive value of CEUS combine with AFP, GGT and GLR for MVI in HCC patients were analyzed by receiver operating characteristic (ROC) curve. Results: The onset time, peak time and clearance time in MVI positive group were shorter than those in MVI negative group (P<0.05). AFP, GGT and GLR in MVI positive group were significantly higher than those in MVI negative group(P<0.05). Multivariate Logistic regression analysis showed that elevated AFP, elevated GGT, elevated GLR, irregular lesion morphology, shortened onset time, shortened peak time, and shortened clearance time were independent risk factors for MVI in HCC patients (P<0.001). The ROC results showed that, the area under the curve of MVI in HCC patients predicted by the combination of serum AFP, GGT and GLR was 0.901, which was significantly larger than that of single detection(P<0.05). Conclusion: The levels of serum AFP, GGT and GLR in patients with MVI after HCC operation increased, and the time of initial increase, peak time and clearance time were shortened, which were independent risk factors for MVI in HCC patients. CEUS combined with AFP, GGT and GLR has a high predictive value for MVI in HCC patients. |
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