普美显增强MRI及DWI相关定量参数对原发性肝癌肝脏储备功能及CD34、Glypican-3表达水平的预测价值  

Predictive value of the gadoxetic acid enhanced MRI combined with diffusion-weighted imaging in liver reserve function and the expression of prognostic molecular markers in patients with primary liver cancer

作　　者：陈松[1] 黄泽和[1] 李莹[2] 李伟雄[3] CHEN Song;HUANG Ze-he;LI Ying(Department of Radiology,Qinzhou First People's Hospital,Guangxi 535000,China)

机构地区：[1]钦州市第一人民医院放射科,广西535000 [2]钦州市第一人民医院病理科,广西535000 [3]广西医科大学第二附属医院放射科,南宁530007

出　　处：《放射学实践》2023年第9期1134-1139,共6页Radiologic Practice

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210262)。

摘　　要：目的:探讨以钆塞酸二钠(Gd-EOB-DTPA,商品名:普美显)为对比剂的动态对比增强磁共振成像(DEC-MRI)定量参数对原发性肝癌肝脏储备功能及CD34、Glypican-3表达水平的预测价值。方法:纳入96例原发性肝癌患者作为研究对象,并选择50例肝良性结节患者作为对照组。使用普美显为对比剂行增强MRI检查,测定并计算肝胆期相对信号强化率(REHBP);行扩散加权成像(DWI)检查并测定表观扩散系数(ADC)值。采用免疫组化评估CD34、Glypican-3表达水平。结果:原发性肝癌患者的REHBP和ADC值均显著低于肝脏良性结节患者,差异有统计学意义(P<0.05)。Child-Pugh肝功能分级B+C级、低分化、Ⅲ~Ⅳ期患者的REHBP和ADC值分别显著低于A级、中高分化和Ⅰ~Ⅱ期患者,差异有统计学意义(P<0.05)。CD34、Glypican-3高表达患者的REHBP和ADC值均显著低于低表达患者,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,REHBP和ADC值预测肝脏储备功能的曲线下面积(AUC)为0.901(95%CI:0.840~0.962,P<0.001)和0.861(95%CI:0.784~0.937,P<0.001),预测CD34高表达的AUC为0.923(95%CI:0.866~0.980,P<0.001)和0.866(95%CI:0.783~0.948,P<0.001),预测Glypican-3高表达的AUC为0.879(95%CI:0.791~0.966,P<0.001)和0.933(95%CI:0.884~0.982,P<0.001)。结论:普美显增强MRI及DWI相关定量参数对原发性肝癌患者肝脏储备功能及预后分子标志物表达具有一定预测价值。Objective:To investigate the predictive value of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(MRI)using gadoxetic acid(Gd-EOB-DTPA,trade name:Pumeixian)as a contrast agent in liver reserve function and the expression levels of CD34 and Glypican-3 in patients with primary liver cancer.Methods:A total of 96 patients with primary liver cancer were included as the research subjects,and 50 patients with benign liver nodules were selected as the control group.Gd-EOB-DTPA was used as the contrast agent for enhanced MRI,and the signal intensity before enhancement(SI pre)and in the hepatobiliary phase(SI post)were recorded for the measurement of REHBP,which equals to(SI post-SI pre)/SI pre.Apparent diffusion coefficient(ADC)from diffusion weighted imaging(DWI)were also calculated.The expression levels of CD34 and Glypican-3 were evaluated by immunohistochemistry.Results:The values of REHBP and ADC in patients with primary liver cancer were significantly lower than those in patients with benign liver nodules,with statistical significance(P<0.05).The RE HBP and ADC values of Child-Pugh liver function grade B+C,poorly differentiated andⅢ~Ⅳpatients were significantly lower than those of grade A,medium-highly differentiated andⅠ~Ⅱpatients,respectively,with statistical significance(P<0.05).The REHBP and ADC values of patients with high expression of CD34 and Glypican-3 were significantly lower than those of patients with low expression,respectively,with statistical significance(P value<0.05).Receiver operating characteristic curve(ROC)analysis showed that the area under the curve(AUC)of REHBP and ADC in predicting liver reserve function was 0.901(95%CI:0.844~0.962,P<0.001)and 0.861(95%CI:0.784~0.937,P<0.001),respectively.The AUC of predicting high CD34 expression was 0.923(95%CI:0.866~0.980,P<0.001)and 0.866(95%CI:0.783~0.948,P<0.001).The AUC of Glypican-3 high expression was 0.879(95%CI:0.791~0.966,P<0.001)and 0.933(95%CI:0.884~0.982,P<0.001).Conclusions:The quantitative parameters of

关 键 词：肝肿瘤 磁共振成像 钆塞酸二钠 扩散加权成像 表观扩散系数 CD34 GLYPICAN-3 

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