增强CT定量分析联合肿瘤标志物检测对肝细胞肝癌和局灶性结节增生鉴别诊断价值  

Value of enhanced computed tomography quantitative analysis combined with tumor marker detec-tion in the differential diagnosis of hepatocellular carcinoma and focal nodular hyperplasia

作　　者：李继刚 常永亮 王利君 Li Jigang;Chang Yongliang;Wang Lijun(Department of CT Laboratory,Department of Radiology,Xinmi Hospital of Traditional Chinese Medicine,Henan 452370,China)

机构地区：[1]河南省新密市中医院放射CT室检验科,452370

出　　处：《实用医技杂志》2022年第4期358-361,共4页Journal of Practical Medical Techniques

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)和局灶性结节增生(FNH)鉴别诊断价值。方法选择新密市中医院2019年1月至2021年1月收治的肝脏占位病变患者116例作为研究对象,所有患者均接受增强CT定量分析与肿瘤标志物检测,并接受手术治疗,术中病理结果作为金标准。记录增强CT定量分析、肿瘤标志物检测及联合检测诊断肝占位性病变的结果与诊断效能,HCC与FNH患者的CT值比较、静或动脉期与肝实质的比值比较、甲胎蛋白(AFP)水平比较。结果病理诊断结果为HCC 65例和FNH 46例,其他5例。联合检测的敏感度(97%)、准确度(98%)高于单独AFP(78%、84%)(χ^(2)=10.263,P=0.001;χ^(2)=14.067,P<0.01),联合检测的准确度高于增强CT定量分析(90%)(χ^(2)=21.155,P<0.01),其敏感度与增强CT(88%)对比无统计学意义(χ^(2)=3.900,P=0.048),增强CT与AFP的敏感度与准确度对比差异无统计学意义(χ^(2)=1.970,P=0.160;χ^(2)=1.944,P=0.163);HCC患者的在平扫、静脉期、动脉期、静脉期强化差值、动脉期强化差的CT值均低于FNH患者(P<0.05);HCC患者在动、静脉期与肝实质的比值小于FNH患者(P<0.05);HCC患者的AFP水平高于FNH(P<0.05)。结论增强CT定量分析联合AFP检测诊断的总体价值高于单独检测,可有效鉴别HCC与FNH。Objective This study aimed to investigate the value of quantitative analysis of enhanced computed tomography(CT)combined with tumour marker detection in the differential diagnosis of hepatocellular carcinoma(HCC)and focal nodular hyperplasia(FNH).Methods A total of 116 patients with liver space-occupying lesions admitted to our hospital from January 2019 to January 2021 were enrolled as the research subjects.All patients underwent enhanced CT quantitative analysis,tumour marker detection,and surgical treatment.Intraoperative pathological results were regarded as the gold standard for diagnosis.The results and diagnostic efficacy of enhanced CT quantitative analysis,tumour marker detection,and combined detection in the diagnosis of liver space-occupying lesions were recorded.Subsequently,we compared the CT values,the ratio of intravenous or arterial phase to liver parenchyma,and alpha-fetoprotein(AFP)levels of patients with HCC and FNH.Results Pathological diagnosis identified 65 cases of HCC and 46 cases of FNH,and the other 5 cases.The sensitivity(97%)and accuracy(98%)of the combined detection were higher than that of alpha-fetoprotein(AFP)alone(78%,84%)(χ^(2)=10.263,P=0.001;χ^(2)=14.067,P<0.01),and the accuracy of the combined detection was higher than enhanced CT(90%)(χ^(2)=21.155,P<0.01),although the difference in sensitivity was not statistically significant(88%)(χ^(2)=3.900,P=0.048).The sensitivity and accuracy of enhanced CT and AFP were compared,revealing no statistically significant difference(χ^(2)=1.970,P=0.160;χ^(2)=1.944,P=0.163).However,the CT values of patients with HCC in plain scan,venous phase,arterial phase,venous phase enhan-cement difference,and arterial phase enhancement difference were lower than those of patients with FNH(P<0.05).The ratio of the arterial and venous phase to liver parenchyma in patients with HCC was lower than that in those with FNH(P<0.05).The AFP levels of patients with HCC were higher than in those with FNH(P<0.05).Conclusion The overall diagnostic value of enhanc

关 键 词：化学定量分析 甲胎蛋白类 诊断 鉴别 

分 类 号：R735.7[医药卫生—肿瘤] R730.44[医药卫生—临床医学]