应用2D-SWE构建肝硬化肝癌切除术后肝功能损伤预测模型  

Building of Predictive Model of Postoperative Liver Function Injury of Cirrhotic Patients after Hepatectomy by Using Two-Dimensional Shear Wave Elastography

作　　者：赫嵘 何楠 王米雪 张瑶[2] He Rong;He Nan;Wang Mixue;Zhang Yao(Department of General Surgery,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Ultrasound,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院普外科,北京市100015 [2]首都医科大学附属北京地坛医院超声科,北京市100015

出　　处：《中国超声医学杂志》2023年第7期772-775,共4页Chinese Journal of Ultrasound in Medicine

基　　金：北京市属医院科研培育计划项目(No.PX2020069)。

摘　　要：目的基于术前二维剪切波弹性成像(2D-SWE)构建肝硬化患者肝癌肝切除术后肝功能损伤(PLFI)预测模型。方法收集因肝癌行手术切除的肝硬化患者资料,按照患者PLFI情况分为PLFI组16例和对照组75例,比较两组影响术后患者肝功能的指标,行多因素logistic回归分析肝切除术后影响肝功能损伤的因素,并构建回归方程。利用受试者工作特征(ROC)曲线分析各参数及预测模型预判术后肝功能损伤的效能。结果2D-SWE测量值是预测PLFI的独立因素(P<0.05),建立预测PLFI的logistic回归模型,行Hosmer-Lemeshow检验提示模型有良好的校准度(χ^(2)=6.300,df=8,P=0.614)。利用ROC曲线检验该模型,同术前Child-Pugh评分相比,模型预测PLFI的AUC值具有显著性差异(Z=2.057,P=0.0396)。结论应用2D-SWE构建肝硬化患者肝癌切除术后肝功能损伤预测模型的效能良好,可作为评估肝硬化患者肝癌切除术后肝功能储备的指标。Objective To create a predictive model of postoperative liver function injury(PLFI)in cirrhotic patients after hepatocellular carcinoma resection based on two-dimensional shear wave elastography(2D-SWE).Methods The data of cirrhotic patients undergoing surgical resection for liver cancer were collected and divided into PLFI group(Child-Push grade B-C,16 cases)and control group(Child-Push grade A,75 cases)according to the PLFI condition.The indicators affecting postoperative liver function of the two groups were compared,and factors affecting liver function injury after hepatectomy were analyzed by multivariate logistic regression,and the regression equation was constructed.The receiver operating characteristic(ROC)curve was used to analyze the parameters and prediction model to predict the efficacy of PLFI.Results 2D-SWE measurements were independent factors for predicting PLFI(P<0.05).Logistic regression model was establised to predict PLFI,and Hosmer-Lemeshow test indicated that the model had good calibration(χ^(2)=6.300,df=8,P=0.614).ROC curve was used to test the regression model.Compared with the preoperative Child-Pugh score,the AUC value of PLFI predicted by the model was significantly different(Z=2.057,P=0.0396).Conclusions The built with 2D-SWE model for predicting PLFI in patients with cirrhosis after hepatectomy is effective and can be used as an indicator to evaluate liver functional reserve after tumor resection in cirrhotic patients.

关 键 词：肝癌切除术 肝硬化 原发性肝癌 二维剪切波弹性成像 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学] R735.7[医药卫生—临床医学]