增强CT定量分析联合肿瘤标志物检测对肝细胞肝癌与局灶性结节增生的鉴别诊断意义  

Differential Diagnosis of Hepatocellular Carcinoma and Focal Nodular Hyperplasia by Enhanced CT Quantitative Analysis Combined with Tumor Marker Detection

作　　者：蔡榆[1] 李烨[1] 黄辉[1] 冯军屏[1] 宋黎涛[1] CAI Yu;LI Ye;HUANG Hui(Seventh People’s Hospital of Shang-hai University of TCM,Shanghai 200137,China)

机构地区：[1]上海中医药大学附属第七人民医院医学影像科,上海200137

出　　处：《中国实验诊断学》2020年第3期390-393,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨增强CT定量分析联合肿瘤标志物检测对肝细胞肝癌(HCC)与局灶性结节增生(FNH)的鉴别诊断价值。方法选择2016年1月至2018年12月90例肝脏占位病变患者(HCC52例、FNH38例)进行回顾性分析,所有患者均接受增强CT检查和进行肿瘤标志物甲胎蛋白检测,观察两组患者的平扫CT值、动静脉期强化CT值、病灶动静脉期CT值与同期肝实质CT值的比值、甲胎蛋白水平。结果HCC组平扫CT值、静脉期CT值、动脉期CT值、静脉期强化CT差值、动脉期强化CT差值均显著低于FNH组,差异有统计学意义(P<0.05);HCC组静、动脉期与肝实质的比值均显著低于FNH组,差异有统计学意义(P<0.05);HCC组AFP水平显著高于FNH组,差异有统计学意义(P<0.05);增强CT定量联合AFP检测肝细胞肝癌的灵敏度和特异度(88.00%、60.34%)均高于单独增强CT定量分析(75.00%、81.57%)及AFP检测(69.23%、65.79%)。结论增强CT定量分析联合肿瘤标志物检测对HCC和FNH鉴别具有较高价值,可提高诊断准确性。Objective To investigate the value of enhanced CT quantitative analysis combined with tumor markers in the differential diagnosis of hepatocellular carcinoma(HCC)and focal nodular hyperplasia(FNH).Methods 90 patients with hepatic lesions(52 cases of HCC and 38 cases of FNH)were retrospectively analyzed from January 2016 to December 2018.All patients underwent enhanced CT examination and detection of tumor marker alpha-fetoprotein.The patient’s plain CT value,the intensive CT value of the arteriovenous phase,the CT value of the diseased arteriovenous phase and the CT value of the liver parenchyma,and the alpha-fetoprotein level.Results The CT values of the plain CT in the HCC group,the CT value in the venous phase,the CT value in the arterial phase,the intensive CT score in the venous phase,and the intensive CT in the arterial phase were significantly lower than those in the FNH group(P<0.05).The ratio of static,arterial phase and liver parenchyma was significantly lower than that of FNH group(P<0.05).The AFP level in HCC group was significantly higher than that in FNH group(P<0.05).The sensitivity and specificity of CT quantitative combined with AFP for hepatocellular carcinoma(88.00%、60.34%)were higher than those of enhanced CT(75.00%、81.57%)and AFP(69.23%、65.79%).Conclusion Enhanced CT quantitative analysis combined with tumor marker detection can improve the value of HCC and FNH identification,and can improve the diagnostic accuracy.

关 键 词：肝细胞肝癌 局灶性结节增生 增强CT 肿瘤标志物 甲胎蛋白 

分 类 号：R735.7[医药卫生—肿瘤]