磁共振成像检查靶环样强化联合甲胎蛋白水平评估肝细胞癌细胞角蛋白19表达状态的应用价值  

Application value of magnetic resonance imaging targetoid enhancement combined with alpha‑fetoprotein level in evaluating the expression of cytokeratin 19 in hepatocellular carcinoma

作　　者：高知玲[1] 舒建军[2] 陈勇[3] 孙长浩 杨冠华 Gao Zhiling;Shu Jianjun;Chen Yong;Sun Changhao;Yang Guanhua(Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Radiology,Shizuishan First People′s Hospital,Shizuishan 753299,Ningxia Hui Autonomous Region,China;Department of Interventional Radiology,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院放射科,银川750004 [2]石嘴山市第一人民医院放射科,石嘴山753299 [3]宁夏医科大学总医院放射介入科,银川750004

出　　处：《中华消化外科杂志》2022年第7期956-965,共10页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(61761039);宁夏自然科学基金(2021AAC03384);宁夏医科大学校级科研项目(XM2021152)。

摘　　要：目的探讨单发肿瘤无大血管侵犯的肝细胞癌行根治性切除术患者术前临床及磁共振成像(MRI)检查靶环样强化联合甲胎蛋白水平评估肝细胞癌细胞角蛋白19(CK19)表达状态的应用价值。方法采用回顾性队列研究方法。收集2016年1月至2020年12月宁夏医科大学总医院收治的220例单发肿瘤无大血管侵犯肝细胞癌行根治性切除术患者的临床病理资料;男171例,女49例;年龄为(56±11)岁。220例患者中,CK19表达阳性52例,CK19表达阴性168例。观察指标:(1)不同CK19表达状态患者MRI检查和免疫组织化学染色检测结果。(2)不同CK19表达状态患者的临床特征比较。(3)不同CK19表达状态患者的MRI检查特征比较。(4)影响患者CK19表达状态的相关因素分析及预测价值。连续变量采用Shapiro‑Wilk进行正态性检验,正态分布的计量资料以x±s表示,组间比较采用t检验。偏态分布的计量资料以M(Q 1,Q 3)表示,组间比较采用Mann‑Whitney U检验。计数资料以绝对数和(或)百分比表示,组间比较采用χ^(2)检验。等级资料比较采用非参数秩和检验。将临床及影像特征比较P<0.05的相关因素纳入二元Logistic回归模型。绘制受试者工作特征(ROC)曲线并以曲线下面积(AUC)评价模型预测效能。结果(1)不同CK19表达状态患者MRI检查和免疫组织化学染色检测结果。CK19表达阳性患者MRI检查结果显示:T1加权成像平扫瘤体呈低信号;动脉期瘤体呈环状高强化;门静脉期瘤体呈周边廓清;延迟期瘤体呈中央强化;弥散加权成像(DWI)瘤体呈靶环样高信号。免疫组织化学染色检测结果显示:CK19表达阳性。CK19表达阴性患者MRI检查结果显示:T1加权成像平扫瘤体呈低信号;动脉期瘤体呈非环状高强化;门静脉期瘤体呈非周边廓清;延迟期瘤体对比周围肝组织呈低信号;DWI瘤体呈均匀高信号。免疫组织化学染色检测结果显示:CK19表达阴性。(2)不同CK19表达�Objective To investigate the application value of preoperative clinical and magnetic resonance imaging(MRI)targetoid enhancement combined with alpha-fetoprotein in evaluating the expression of cytokeratin 19(CK19)in patients undergoing radical resection for single hepatocellular carcinoma(HCC)without macrovascular invasion.Methods The retrospective cohort study was conducted.The clinicopathological data of 220 patients who underwent radical resection for single HCC without macrovascular invasion in the General Hospital of Ningxia Medical University from January 2016 to December 2020 were collected.There were 171 males and 49 females,ag(56±11)years.Of the 220 patients,52 cases showed positive CK19 expression,while 168 cases showed negative CK19 expression.Observation indicators:(1)MRI and immunohistochemical staining resul of patients with different status of CK19 expression;(2)comparison of clinical features of patients with different status of CK19 expression;(3)comparison of MRI features in patients with different status of CK19 expression;(4)analysis of influencing factors for CK19 expression in patients and predictive value.The normality of continuous variables was tested using the Shapiro‐Wilk test.Measurement data with normal distribution were expressed as Mean±SD,and comparison between groups was conducted using the t test.Measurement data with skewed distribution were expressed as M(Q_(1),Q _(3)),and comparison between groups was conducted using the Mann‐Whitney U test.Count data were expressed as absolute numbers and(or)percentages,and comparison between groups was conducted using the chi‐square test.Comparison of ordinal data was analyzed by the non-parameter rank sum test.The relevant clinical and imaging features with P<0.05 were included in the binary Logistic regression model.The receiver operating characteristic(ROC)curve was drawn and the area under curve(AUC)was used to evaluate the predictive efficiency of the model.Results(1)MRI and immunohistochemical staining results of patients with

关 键 词：肝肿瘤 磁共振成像 细胞角蛋白19 危险因素 预测 

分 类 号：R735.7[医药卫生—肿瘤]