MRI扩散加权成像联合外周血CD4+/CD8+比值预测CalliSpheres载药微球栓塞介入治疗晚期肝癌疗效的价值  

Value of MRI diffusion weighted imaging combined with peripheral blood CD4+/CD8+ ratio in predicting the efficacy of CalliSpheres drug-loaded microsphere embolization interventional therapy for advanced hepatocellular carcinoma

作　　者：蔡争 宋建涛 甄文瑞 梁乐乐 叶映雪 CAI Zheng;SONG Jian-tao;ZHENG Wen-rui(Department of Interventional,The Second Affiliated Hospital of Zunyi Medical University,Guizhou 563000,China)

机构地区：[1]遵义医科大学第二附属医院介入科,贵州563000

出　　处：《放射学实践》2023年第1期84-88,共5页Radiologic Practice

摘　　要：目的:探讨MRI扩散加权成像联合外周血CD4+/CD8+比值预测CalliSpheres载药微球栓塞介入治疗晚期肝癌疗效的价值。方法:选择2020年1月至2022年6月于遵义医科大学第二附属医院就诊并接受CalliSpheres载药微球栓塞介入治疗的40例晚期肝癌患者作为研究对象。治疗前行MRI扩散加权成像检查,记录表观扩散系数(ADC)值。采用流式细胞仪测定CD4+和CD8+T细胞的数值,计算并记录CD4+/CD8+比值。采用CalliSpheres载药微球栓塞介入治疗,治疗结束后采用美国肝病协会提出的改良实体瘤评价标准评估患者治疗效果,分为有效组和无效组。结果:共26例(65.00%)患者经CalliSpheres载药微球栓塞介入治疗后有效(有效组),14例(35.00%)患者治疗后无效(无效组)。有效组与无效组患者的性别、年龄、病因、Child-Pugh分级、卡氏评分、肿瘤大小、肿瘤数量、有无血管侵犯、有无肿瘤包膜比较差异均无统计学意义(P>0.05)。有效组的ADC值为(1.31±0.16)×10-3mm2/s,显著高于无效组[(1.05±0.20)×10-3mm2/s],差异有统计学意义(t=4.552,P<0.001);有效组的外周血CD4+/CD8+比值为(1.29±0.18),显著高于无效组(1.04±0.13),差异有统计学意义(t=4.657,P<0.001)。ADC值、外周血CD4+/CD8+比值及两者联合预测肝癌患者经CalliSpheres载药微球栓塞介入治疗后疗效的AUC分别为0.876(95%CI:0.772~0.980)、0.824(95%CI:0.692~0.956)和0.918(95%CI:0.831~0.995)。结论:MRI扩散加权成像ADC值联合外周血CD4+/CD8+比值预测CalliSpheres载药微球栓塞介入治疗晚期肝癌的疗效具有一定价值。Objective:This study aimed toTo investigate the value of MRI diffusion weighted imaging combined with peripheral blood CD4+/CD8+ ratio in predicting the efficacy of CalliSpheres drug-loaded microsphere embolization interventional therapy for advanced liver cancer.Methods:A total of 146 Forty patients with advanced liver cancer who were treated in The Second Affiliated Hospital of Zunyi Medical University from January 2020 to June 2022 and received CalliSpheres drug-loaded microsphere embolization and interventional therapy were selected as the research study objects.Before treatment, MRI was used to examine the diffusion weighted imaging was performed, and the apparent diffusion coefficient(ADC) value was recorded.The values of CD4+ and CD8+ T cells were measured by flow cytometry, and the ratio of CD4+/CD8+ was calculated and recorded.The patients were treated with CalliSpheres drug-loaded microsphere embolization and interventional therapy.After the treatment, the modified solid tumor evaluation criteria proposed by the American Liver Disease Association were used to evaluate the treatment effect of, and the patients, who were divided into effective group and ineffective group.Results:A total of 94 26 patients(65.00%) were effective after CalliSpheres drug-loaded microsphere embolization intervention(effective group),and 14 patients(35.00%) were ineffective after treatment(ineffective group).There were no significant differences in gender, age, etiology, Child-Pugh grade, and Carver score, tumor size, tumor number, vascular invasion and tumor capsule distribution between the effective group and the ineffective group(P>0.05).The ADC value of effective group was(1.31±0.16)×10-3mm~2/s, which was significantly higher than that of ineffective group [(1.05±0.20)×10-3mm~2/s],and the difference was statistically significant(t=4.552,P<0.001).The ratio of CD4+/CD8+ in peripheral blood of the effective group was(1.29±0.18),which was significantly higher than that of the ineffective group(1.04±0.13),and the differenc

关 键 词：肝肿瘤 CalliSpheres载药微球栓塞 介入治疗 扩散加权成像 表观扩散系数 CD4+/CD8+比值 疗效 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]