肝细胞癌患者射频消融术后24 h超声造影联合血清miRNA-182-5p对消融效果及术后复发的预测价值  

Predictive value of contrast-enhanced ultrasound combined with serum miRNA-182-5p in the ablation outcome and postoperative recurrence for patients with hepatocellular carcinoma 24 h after radiofrequency ablation

作　　者：胥莲江 李文强 王晋梅 Xu Lianjiang;Li Wenqiang;Wang Jinmei(Department of Functional Examination,Sichuan Luzhou TCM Hospital,Luzhou 646000,China)

机构地区：[1]泸州市中医医院功能科,泸州646000

出　　处：《肿瘤研究与临床》2024年第4期279-284,共6页Cancer Research and Clinic

摘　　要：目的探讨肝细胞癌(HCC)患者射频消融术后24 h超声造影定量参数联合血清miRNA-182-5p(miR-182-5p)在预测消融效果及术后复发方面的价值。方法回顾性病例系列研究。回顾性分析泸州市中医医院2018年6月至2020年6月收治的113例行射频消融治疗的HCC患者临床资料。患者均于术后24 h行超声造影检查,记录相关定量参数,包括上升时间(RT)、峰值强度(PI)、达峰时间(TTP)。术后24 h采集患者外周静脉血,采用实时定量聚合酶链反应检测血清miR-182-5p水平。分析患者术后1个月消融效果及术后2年复发情况,比较完全消融组与未完全消融组、复发组与未复发组患者射频消融术后24 h超声造影定量参数与血清miR-182-5p水平。绘制受试者工作特征(ROC)曲线分析肝癌患者射频消融术后24 h超声造影定量参数与miR-182-5p预测患者消融效果及术后复发的效能。结果113例患者年龄(47±11)岁,包括男性70例,女性43例。未完全消融组术后24 h超声造影PI、RT、TTP及血清miR-182-5p水平均低于完全消融组[(135.46±19.58)dB比(195.52±23.59)dB、(9.49±1.13)s比(11.99±1.65)s、(11.46±1.79)s比(15.35±2.16)s、0.43±0.11比0.66±0.13],差异均有统计学意义(t值分别为10.84、6.59、7.67、6.53,均P<0.05)。复发组患者术后24 h超声造影PI、RT、TTP及血清miR-182-5p水平均低于未复发组[(141.74±22.48)dB比(192.46±23.25)dB、(8.16±1.74)s比(12.16±2.12)s、(10.03±1.79)s比(15.49±2.41)s、0.35±0.08比0.67±0.11],差异均有统计学意义(t值分别为8.53、7.53、9.13、11.75,均P<0.05)。ROC曲线显示,超声造影RT、TTP及血清miR-182-5p预测消融效果的曲线下面积(AUC)分别为0.751、0.802、0.786,三者联合的AUC则为0.890;术后24 h超声造影RT、TTP及血清miR-182-5p预测患者术后复发的AUC分别为0.772、0.782、0.773,三者联合的AUC则为0.882。结论HCC患者射频消融术后24 h超声造影RT、TTP以及血清miR-182-5p在预测消融效果及术�Objective To investigate the value of quantitative parameters of contrast-enhanced ultrasound(CEUS)combined with serum miRNA-182-5p(miR-182-5p)in predicting radiofrequency ablation(RFA)outcome and postoperative recurrence for patients with hepatocellular carcinoma(HCC)24 h after RFA.Methods A retrospective case series study was performed.The clinical data of 113 HCC patients treated with RFA from June 2018 to June 2020 in Sichuan Luzhou TCM Hospital were retrospectively analyzed.All patients underwent CEUS examination 24 h after surgery,and the related quantitative parameters including rise time(RT),peak intensity(PI)and time to peak(TTP)were recorded.Peripheral venous blood of patients was collected 24 h after surgery,and real-time quantitative polymerase chain reaction was used to detect the level of serum miR-182-5p.The results of ablation 1 month after surgery and recurrence 2 years after surgery were analyzed.The quantitative parameters of CEUS and the serum miR-182-5p level 24 h after RFA were compared between the complete ablation group and the incomplete ablation group,and between the recurrence group and the non-recurrence group;and the receiver operating characteristic(ROC)curve was plotted to analyze the efficacy of CEUS quantitative parameters and miR-182-5p in predicting RFA outcome and postoperative recurrence for patients with HCC 24 h after RFA.Results The age of 113 patients was(47±11)years,and there were 70 males and 43 females.CEUS quantitative parameters PI,RT,TTP and serum miR-182-5p levels of patients in the incomplete ablation group were lower than those of patients in the complete ablation group 24 h after surgery[(135.46±19.58)dB vs.(195.52±23.59)dB,(9.49±1.13)s vs.(11.99±1.65)s,(11.46±1.79)s vs.(15.35±2.16)s,0.43±0.11 vs.0.66±0.13],and the differences were statistically significant(t=10.84,6.59,7.67,6.53,all P<0.05).CEUS quantitative parameters PI,RT,TTP and serum miR-182-5p levels of patients in the recurrence group were lower than those of patients in non-relapsed group 24 h a

关 键 词：肝肿瘤 射频消融 超声造影 miRNA-182-5p 预后 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]