超声造影结合血清P53抗体鉴别肝细胞癌分化程度的价值探讨  

Value of contrast-enhanced ultrasonography combined with serum P53 antibody in distinguishing differentiation degree of hepatocellular carcinoma

作　　者：陈媛媛 朱春雨[2] CHEN Yuanyuan;ZHU Chunyu(Department of Ultrasound,Zhoukou Central Hospital,Zhoukou,Henan 466000,China;RICU,Zhoukou Central Hospital,Zhoukou,Henan 466000,China)

机构地区：[1]周口市中心医院超声科,河南周口466000 [2]周口市中心医院RICU,河南周口466000

出　　处：《中国医学工程》2024年第2期52-57,共6页China Medical Engineering

摘　　要：目的探讨超声造影结合血清P53抗体对肝细胞癌分化程度的鉴别价值。方法回顾性分析2020年3月至2023年3月周口市中心医院收治的经病理学检查确诊的185例肝细胞癌患者的临床资料,均于入院后行超声造影检查与血清P53抗体检测。根据肝细胞癌病理分化程度,将患者分化高分化组(n=48)、中分化组(n=82)、低分化组(n=55)。比较不同分化程度患者超声造影参数(开始增强时间、达峰时间、峰值强度、增强持续时间、开始廓清时间)和血清P53抗体水平。分析超声造影、血清P53抗体各自单独及二者联合对肝细胞癌分化程度的鉴别价值。结果高分化、中分化、低分化肝细胞癌患者超声造影开始增强时间、峰值强度比较,差异无统计学意义(P>0.05)。超声造影达峰时间、增强持续时间、开始廓清时间在高分化、中分化、低分化患者中逐渐降低(P<0.05),血清P53抗体水平在高分化、中分化、低分化患者中逐渐升高(P<0.05)。超声造影达峰时间、增强持续时间、开始廓清时间各自单独及联合鉴别肝细胞癌低分化与中高分化的灵敏度分别为65.45%、67.27%、69.09%、85.45%,特异度分别为89.23%、87.69%、86.15%、82.31%,曲线下面积(AUC)分别为0.771、0.772、0.781、0.833。血清P53抗体水平鉴别肝细胞癌低分化与中高分化的灵敏度、特异度、AUC分别为83.64%、83.08%、0.836,超声造影联合血清P53抗体鉴别肝细胞癌低分化与中高分化的灵敏度、特异度、AUC分别为96.36%、81.54%、0.930,两项联合鉴别的灵敏度与AUC均较各项单独鉴别高(P<0.05)。结论超声造影与血清P53抗体均可提示肝细胞癌分化程度,但两项联合鉴别的价值更佳。【Objective】To explore the differential value of contrast-enhanced ultrasonography combined with serum P53 antibody in the degree of differentiation of hepatocellular carcinoma.【Methods】The clinical data of 185 patients with hepatocellular carcinoma diagnosed through pathological examination admitted to our hospital from March 2020 to March 2023 were retrospectively analyzed,and they all underwent contrast-enhanced ultrasonography examination and serum P53 antibody testing after admission.According to the pathological differentiation degree of hepatocellular carcinoma,the patients were divided into high differentiation group(n=48),moderate differentiation group(n=82)and low differentiation group(n=55).The contrast-enhanced ultrasonography parameters(beginning enhancement time,peak time,peak intensity,enhancement duration,starting clearance time)in patients with different degrees of differentiation and serum P53 antibody level were compared.The differential value of contrast-enhanced ultrasonography and serum P53 antibody alone or in combination for the differentiation degree of hepatocellular carcinoma were analyzed.【Results】There was no statistically significant difference in the beginning enhancement time and peak intensity of contrast-enhanced ultrasonography in patients with high differentiation,moderate differentiation,and low differentiation hepatocellular carcinoma(P>0.05).The peak time,enhancement duration,and starting clearance time of contrast-enhanced ultrasonography gradually decreased in high differentiation,moderate differentiation and low differentiation patients(P<0.05),but the serum P53 antibody level gradually increased in high differentiation,moderate differentiation and low differentiation patients(P<0.05).The sensitivity of peak time,enhancement duration and starting clearance time of contrast-enhanced ultrasonography alone and in combination for distinguishing low differentiation and medium to high differentiation of hepatocellular carcinoma were 65.45%,67.27%,69.09%and 85.45%resp

关 键 词：肝细胞癌 超声造影 P53抗体 分化程度 

分 类 号：R735.7[医药卫生—肿瘤]