肝硬化背景下细胞角蛋白19不同表达的肝细胞癌超声造影量化参数分析  

Quantitative analysis of contrast-enchancement ultrasound parameters on hepatocellular carcinoma with different cytokeratin-19 expression in background cirrhosis

作　　者：张溢[1] 李锐[1] 张晓航[1] 段光杰[2] 郭燕丽[1] 唐春霖[1] 陈朝晖[1] 

机构地区：[1]第三军医大学西南医院超声科,重庆400038 [2]第三军医大学西南医院病理科,重庆400038

出　　处：《中华医学超声杂志（电子版）》2014年第4期59-62,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的分析肝硬化背景下细胞角蛋白19(CK19)表达阳性与阴性的肝细胞癌(HCC)超声造影量化参数的差异。方法收集2005年6月至2013年10月第三军医大学西南医院收治的164例经手术或穿刺活检病理证实为HCC及肝硬化患者超声造影检查资料,其中79例患者CK19阳性,85例患者CK19阴性。使用DFY-Ⅱ型超声图像定量分析仪分别测量、计算CK19阳性与CK19阴性HCC超声造影动脉期增强不均匀度、峰值强度,超声造影门脉期增强强度,肿瘤及肿瘤旁肝实质超声造影门脉期增强强度比值,并进行比较。结果 CK19阳性HCC超声造影动脉期增强不均匀度高于CK19阴性HCC(2.64±0.64 vs 2.29±0.31),CK19阳性HCC超声造影动脉期峰值强度低于CK19阴性HCC[(102.83±29.78)dB vs(120.65±25.49)dB],CK19阳性HCC超声造影门脉期增强强度低于CK19阴性HCC[(66.83±20.13)dB vs(79.99±27.15)dB],CK19阳性HCC肿瘤与肿瘤旁肝实质超声造影门脉期增强强度比值低于CK19阴性HCC(0.74±0.03 vs 0.92±0.22),且差异均有统计学意义(W=4.4,P=0.000;t=3.887,P=0.000;t=3.115,P=0.002;t=5.221,P=0.000)。结论肝硬化背景下CK19不同表达的HCC超声造影量化参数存在明显差异。Objective To explore contrast-enchancement ultrasound （CEUS） parameters of hepatocellular carcinoma （HCC） with different cytokeratin-19 （CK19） expression in the background of cirrhosis.Methods CEUS data of pathologically proven HCC in patients with cirrhosis in Southwest Hospital from June 2005 to October 2013 were collected in this retrospective study. Two groups were classified on the basis of different CK19 expression in HCC patients： CK19 positive group （seventy-nine patients） and CK19 negative group （eighty-ifve patients）. DFY-II Ultrasound Imaging Analysis Software was utilized to measure and calculate CEUS paramrters, including the enhancement heterogeneity of the tumor and peak intensity in arterial phase, the enhancement intensity of tumor and the enhancement ratio of tumor/adjacent liver parenchyma in portal phase. The difference between the two groups was compared by statistics test. Results TThe arterial phase enhancement heterogeneity of tumor in CK19 positive group was higher than that of the negative group （2.64±0.64 vs 2.29±0.31）. The arterial phase peak intensity of tumor in CK19 positive group was lower than that of the negative group [（102.83±29.78）dB vs （120.65±25.49）dB]. The portal phase enhancement intensity of tumor in CK19 positive group was lower than that of the negative group [（66.83±20.13） dB vs （79.99±27.15） dB ].The enhancement ratio of tumor/adjacent liver parenchyma in portal phase was lower in CK19 positive group than that in the negative group （0.74±0.03 vs＆amp;nbsp;0.92±0.22）. All above comparisons had significant differences between two group. Conclusions The CEUS enhancement parameters had signiifcant difference between the CK19 positive HCC and negative HCC in patient with background cirrhosis.

关 键 词：癌 肝细胞 超声检查 造影剂 角蛋白19 Keratin-19 

分 类 号：R575.2[医药卫生—消化系统] R735.7[医药卫生—内科学]