超声造影结合血清ALT与AST比值对胃肠道间质瘤与结直肠癌肝转移的鉴别诊断价值  

Value of Contrast-Enhanced Ultrasound Combined with Serum ALT and AST Ratio in the Differential Diagnosis of Gastrointestinal Stromal Tumor and Colorectal Cancer with Liver Metastasis

作　　者：黄俊[1] 沈才淋 周克松 毛璐瑶 吕镕桔 HUANG Jun;SHEN Cai-lin;ZHOU Ke-song-;MAO Lu-yao;LU Rong-ju(Department of Ultrasonography,Yibin Second People's Hospital·Yibin Hospital of West China Hospital of Sichuan University,Yibin,Sichuan,644000,China)

机构地区：[1]宜宾市第二人民医院·四川大学华西医院宜宾医院超声科,四川宜宾644000

出　　处：《现代生物医学进展》2024年第2期319-323,共5页Progress in Modern Biomedicine

基　　金：四川省2017年卫生和计划生育科研项目(17PJ527)。

摘　　要：目的:探讨超声造影(CEUS)结合血清丙氨酸氨基转移酶(ALT)与天门冬氨酸氨基转移酶(AST)比值(LSR)对胃肠道间质瘤肝转移(GISTLM)与结直肠癌肝转移(CRCLM)的鉴别诊断价值。方法:选择2019年01月-2022年12月宜宾市第二人民医院收治的34例GISTLM患者(GISTLM组)和48例CRCLM患者(CRCLM组)的临床资料,所有患者术前均行CEUS检查和血清ALT与AST检测,术后均经病理证实。比较两组CEUS定量参数、血清LSR的差异;通过绘制受试者工作特征曲线(ROC)并计算曲线下面积(AUC)分析CEUS定量参数、血清LSR单独或联合对GISTLM的鉴别诊断效能。结果:GISTLM组患者肝脏病灶囊性/囊实性成分、无回声/低回声所占比例显著高于CRCLM组(P<0.05)。GISTLM组患者CEUS定量参数[上升时间(RT)、达峰值强度(PI)、达峰时间(TTP)、平均渡越时间(MTT)]以及LSR显著高于CRCLM组(P<0.05)。与单独诊断相比较,CEUS定量参数结合血清LSR诊断GISTLM的AUC、约登指数、敏感度、特异度最高(P<0.05)。结论:CEUS定量参数结合血清LSR有助于提高GISTLM与CRCLM的鉴别诊断,为临床治疗方案的选择提供真实客观的临床证据。Objective:To explore the value of contrast-enhanced ultrasound(CEUS)combined with serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)ratio(LSR)in the differential diagnosis of gastrointestinal stromal tumor liver metastasis(GISTLM)and colorectal cancer liver metastasis(CRCLM).Methods:The clinical data of 34 patients with GISTLM(GISTLM group)and 48 patients with CRCLM(CRCLM group)admitted to Yibin Second People's Hospital from January 2019 to December 2022 were selected.All patients underwent CEUS examination and serum ALT and AST tests before operation.All patients were confirmed by pathology after operation.The differences of CEUS quantitative parameters and serum LSR between the two groups were compared;The differential diagnostic efficacy of CEUS quantitative parameters and serum LSR alone or in combination for GISTLM was analyzed by drawing the subject working characteristic curve(ROC)and calculating the area under the curve(AUC).Results:The proportion of cystic/cystic-solid components and anechoic/hypoechoic of liver lesions in GISTLM group was significantly higher than that in CRCLM group(P<0.05).CEUS quantitative parameters[rise time(RT),peak intensity(PI),peak time(TTP),mean transit time(MTT)]and LSR in GISTLM group were significantly higher than those in CRCLM group(P<0.05).Compared with single diagnosis,the AUC,Yoden index,sensitivity and specificity of CEUS quantitative parameters combined with serum LSR in diagnosis of GISTLM were the highest(P<0.05).Conclusion:CEUS quantitative parameters combined with serum LSR can help improve the differential diagnosis of GISTLM and CRCLM,and provide real and objective clinical evidence for the selection of clinical treatment plan.

关 键 词：超声造影 ALT与AST比值 胃肠道间质瘤肝转移 结直肠癌肝转移 鉴别诊断 

分 类 号：R735.3[医药卫生—肿瘤] R445.13[医药卫生—临床医学]