超声造影联合血γ-GT水平在原发性肝癌患者TACE术后疗效评估中的价值  

The value of using contrast-enhanced ultrasound in combination with blood γ-GT level to evaluate the efficacy of transcatheter arterial chemoembolization therapy for patients with primary hepatic carcinoma

作　　者：李丛辉[1] 罗红缨[1] 王建钧[2] 邝学军[2] 鲍永慧[1] LI Cong-hui;LUO Hong-ying;WANG Jian-jun;KUANG Xue-jun;BAO Yong-hui(Department of Ultrasonography,Affiliated Hospital of Xiangnan University,Chenzhou 423000,China;Department of Hepatobiliary Surgery,Affiliated Hospital of Xiangnan University,Chenzhou 423000,China)

机构地区：[1]湘南学院附属医院超声科,郴州423000 [2]湘南学院附属医院肝胆外科,郴州423000

出　　处：《肝脏》2021年第3期266-269,共4页Chinese Hepatology

基　　金：2018年湖南省教育厅科学研究项目(18C1026)。

摘　　要：目的分析超声造影(CEUS)联合血γ-谷氨酰转肽酶(γ-GT)水平在原发性肝癌(PHC)患者经导管动脉栓塞术(TACE)术后疗效评估中的价值。方法 80例接受TACE介入治疗的PHC患者,患者治疗前后均进行CEUS检查,于术前及术后7 d、28 d、2个月检测血γ-GT水平。结果 80例PHC患者接受TACE介入治疗前均进行CEUS检查,共发现109个病灶,表现为动脉期均匀性或不均匀性高增强;经TACE介入治疗后2个月,CEUS检查显示35例患者37个病灶完全灭活,45例患者72个病灶为肿瘤残留;术后7 d,PHC患者血γ-GT水平较术前明显上升(P<0.05),术后28 d,γ-GT水平较术前、术后7 d明显下降(P<0.05),术后2个月,γ-GT水平较术前、术后7 d、28 d明显下降(P<0.05);联合检测诊断PHC的灵敏度、阳性预测值、阴性预测值以及诊断符合率高于γ-GT检测(P<0.05),与CEUS检查差异比较,不具有统计学意义(P>0.05)。结论 CEUS检查可对PHC患者TACE术后残留病灶进行准确诊断,联合血γ-GT水平检测可提高对PHC诊断的敏感度,降低误诊、漏诊率,在PHC患者TACE术后疗效评估中具有一定的应用价值。Objective To analyze the value of using contrast-enhanced ultrasound(CEUS)in combination with bloodγ-glutamyltransferase(γ-GT)level to evaluate the efficacy of transcatheter arterial chemoembolization(TACE)therapy for patients with primary hepatocellular carcinoma(PHC). Methods Eighty PHC patients who underwent TACE interventional therapy were selected.CEUS was performed in all patients before and after TACE.Blood γ-GT level was detected before TACE and at 7 d,28 d and 2 months after the surgery.The value of combine CEUS examination with bloodγ-GT level to evaluate the efficacy of TACE on PHC patients was analyzed.Results CEUS examination was performed in80 patients with PHC before TACE.A total of 109 lesions were found,showing mild and diffuse enhancement.At 2 months after TACE,CEUS re-examination showed that 37 lesions in35 patients were completely destroyed,and 72 lesions in 45 patients were residual tumors.At 7 d after surgery,the blood γ-GT level in PHC patients was significantly increased compared with that of before surgery(P<0.05),and theγ-GT level at 28 d after surgery was significantly decreased compared with those of before surgery,and 7 d after surgery(P<0.05).The γ-GT level at 2 months after surgery was significantly lower than that of before surgery and those of 7 d and 28 d after surgery(P<0.05).The sensitivity,positive predictive value,negative predictive value and diagnostic coincidence rate of the combined detection for the diagnosis of PHC were higher than those ofγ-GT detection(P<0.05),and there were no statistical differences when compared with those of CEUS examination(P>0.05).Conclusion CEUS examination can accurately diagnose residual lesions in patients with PHC after TACE.The combination of CEUS with blood γ-GT level increase the sensitivity for diagnosing PHC,and reduce the misdiagnosis and missed diagnosis rates.It has certain application value for evaluating the efficacy of TACE therapy for PHC patients.

关 键 词：超声造影 Γ-GT 原发性肝癌 TACE术 疗效评估 

分 类 号：R735.7[医药卫生—肿瘤]