肝癌患者超声造影参数与病理分级和甲胎蛋白的相关性研究  

Study on the correlations among contrast-enhanced ultrasound parameters,pathological grading and alpha-fetoprotein in patients with liver cancer

作　　者：范智慧 吴侠 黄玮[1] 李晶晶 Fan Zhihui;Wu Xia;Huang Wei;Li Jingjing(Department of Ultrasound Medicine,Kailuan General Hospital of Tangshan City,Tangshan 063000,China)

机构地区：[1]开滦总医院超声医学科,唐山063000

出　　处：《中国医学装备》2024年第5期11-15,共5页China Medical Equipment

基　　金：河北省2021年度医学科学研究课题计划(20210402)。

摘　　要：目的:探究对比增强超声(CEUS)造影下增强、达峰和消退时间与肝细胞癌(HCC)诊断中的病理分级和甲胎蛋白(AFP)的相关性,为CEUS的应用提供科学依据。方法:选取2018年6月至2020年2月开滦总医院诊治的304例HCC患者,对所有患者进行常规CEUS扫描,并对患者进行血清AFP检测;采用世界卫生组织(WHO)种类分类及诊断标准系列方法完成肝癌分级;采用Cox回归分析CEUS特征参数与年龄、性别、AFP、肿瘤分级和肿瘤大小的相关性。结果:350例HCC患者肝结节直径为9.0~146.2 mm,平均最大直径为42.5 mm。经Cox回归分析,血清AFP水平是CEUS动脉期检查结果的重要影响因素(HR=1.83,P<0.05);瘤内供血动脉与血清AFP水平、肿瘤大小与CEUS动脉期增强呈正相关(r=0.231、0.483,P<0.05),其中与肿瘤大小的相关性最强。结论:血清AFP水平与CEUS动脉期增强、达峰和消退时间等测定结果相关,其表达水平常受到血清AFP、肿瘤大小等因素影响。Objective: To explore the correlations among contrast-enhanced ultrasound(CEUS) enhancement, time to peak and resolution time, and pathological grading and alpha fetoprotein(AFP) in diagnosing hepatocellular carcinoma(HCC), so as to provide scientific basis for the CEUS application. Methods: A total of 350 HCC patients who admitted to Kailuan General Hospital of Tangshan City, Hebei Province from June 2018 to February 2020 were selected. All patients underwent routine CEUS scanning and AFP detection that was performed by using Roche e411 electrochemiluminescence immunoassay analyzer. Using World Health Organization(WHO) Category Classification and Diagnostic Criteria Series to complete grading for liver cancer. The COX regression analysis was adopted to analyze the correlation between CEUS characteristic parameters and age, AFP, tumor grading, tumor size and gender. Results: The diameter of liver nodules of 304 HCC patients ranged from 9.0 to 146.2 mm, which maximum average diameter was 42.5 mm. The COX analysis indicated that serum AFP level was important influencing factor on CEUS examination results at arterial phase(HR=1.83,P<0.05). The blood supply artery within the tumor appeared positive correlation with serum AFP level, and the tumor size appeared positive correlation with the CEUS enhancement at arterial phase(r=0.231, 0.483, P<0.05), and the correlation between CEUS enhancement at arterial phase and tumor size was strongest. Conclusion: The serum AFP level is correlated with the measured results of CEUS enhancement at arterial phase, time to peak and resolution time,which expression level is often influenced by some factors such as serum AFP and tumor size. It can provide reference for subsequent diagnosis and treatment.

关 键 词：对比增强超声(CEUS) 病理分级 甲胎蛋白(AFP) 肝癌 相关性 

分 类 号：R445.1[医药卫生—影像医学与核医学]