CT灌注成像对原发性肝癌患者介入术治疗预后的评估价值  

Evaluation Value of CT Perfusion Imaging for Prognosis of Patients with Primary Liver Cancer After Interventional Therapy

作　　者：郑龙 何慕真[2] ZHENG Long;HE Mu-zhen(The Second Hospital of Fuqing,Fujian Fuqing 350300;Provincial Clinical College of Medicine,Fujian Medical University,Fujian Provincial Hospital,Fujian Fuzhou 350001)

机构地区：[1]福清市第二医院,福建福清350300 [2]福建医科大学省立临床医学院,福建省立医院,福建福州350001

出　　处：《中国医疗器械信息》2024年第2期23-26,共4页China Medical Device Information

摘　　要：目的:探讨CT灌注成像(CTPI)对原发性肝癌患者介入术治疗预后的评估价值。方法:选取2019年1月~2022年1月在本院接受TACE治疗的原发性肝癌患者150例作为研究对象,在TACE前、TACE后1周分别进行CTPI检查并获取肝血流量(HBF)、肝动脉灌注量(HAP)、达峰时间(TTP)、肝动脉灌注指数(HPI)等在内的参数值。根据TACE近期预后将所有入组患者分为客观缓解组(n=97)、未缓解组(n=53),对比其CTPI参数值、血液肿瘤指标水平的差异并分析其相关性。长期随访生存结局并将患者分为存活组(n=31)、死亡组(n=119),对比其CTPI参数值差异并分析该指标对生存预后的早期预警价值。结果:治疗3个月后,客观缓解组患者的HBF、HAP、HPI低于未缓解组患者,TTP高于未缓解组患者(P<0.05);外周血AFP、VEGF、MMP-9水平低于未缓解组患者(P<0.05)。Pearson检验发现,原发性肝癌患者的HBF、HAP、HPI与血液AFP、VEGF、MMP-9水平呈正相关,TTP与血液AFP、VEGF、MMP-9水平呈负相关(P<0.05)。治疗后3个月,存活组患者的HBF、HAP、HPI低于死亡组患者,TTP高于死亡组患者(P<0.05)。ROC曲线显示,HBF、HAP、HPI、TTP分别对原发性肝癌患者的TACE存活预后具有早期预测价值。结论:CTPI参数值检测与原发性肝癌患者的TACE近期疗效相关,且在患者的远期生存结局预测方面具有一定价值。Objective:To evaluate the prognostic value of CT perfusion imaging(CTPI)in patients with primary liver cancer after interventional therapy.Methods:A total of 150 patients with primary liver cancer who received TACE treatment in our hospital from January 2019 to January 2022 were selected as research objects.CTPI examinations were performed before TACE and one week after TACE,and parameters such as hepatic blood flow(HBF),hepatic artery perfusion volume(HAP),peak time(TTP),and hepatic artery perfusion index(HPI)were obtained.According to the short-term prognosis of TACE,all enrolled patients were divided into objective response group(n=97)and non-response group(n=53).The differences of CTPI parameter values and blood tumor indexes were compared and the correlation was analyzed.After long-term follow-up,the patients were divided into survival group(n=31)and death group(n=119).The difference of CTPI parameters was compared and the early warning value of this index for survival prognosis was analyzed.Results:After 3 months of treatment,HBF,HAP and HPI in objective remission group were lower than those in non-remission group,while TTP was higher than those in non-remission group(P<0.05).The levels of AFP,VEGF and MMP-9 in peripheral blood were lower than those in non-remission group(P<0.05).Pearson test showed that HBF,HAP and HPI were positively correlated with blood AFP,VEGF and MMP-9 levels in patients with primary liver cancer,while TTP was negatively correlated with blood AFP,VEGF and MMP-9 levels(P<0.05).3 months after treatment,HBF,HAP and HPI in the survival group were lower than those in the death group,while TTP was higher than those in the death group(P<0.05).ROC curve showed that HBF,HAP,HPI and TTP had early predictive value for TACE survival in patients with primary liver cancer,respectively.Conclusion:CTPI parameter value detection is related to the short-term efficacy of TACE in patients with primary liver cancer,and has certain value in predicting the long-term survival outcome of patients.

关 键 词：原发性肝癌 CT灌注成像 经肝动脉化疗栓塞术 预后 

分 类 号：R735.7[医药卫生—肿瘤]