CT灌注参数联合血清TGF-β1水平检测对中晚期肝癌TACE治疗预后的预测价值  

Prognostic value of CT perfusion parameters combined with serum TGF-β1 level in patients with advanced liver cancer treated with TACE

作　　者：郭孟珂 杨洁 Guo Meng-ke;Yang Jie(Department of Medical Imaging,The First Affiliated Hospital of Henan University,Kaifeng 475000,Henan,China)

机构地区：[1]河南大学第一附属医院医学影像科,河南开封475000

出　　处：《四川生理科学杂志》2024年第11期2367-2369,2572,共4页

基　　金：2022年度开封市科技发展计划项目磁共振IVIM-DWI联合CT影像组学在开细胞肝癌病理分级中的应用(课题编号:2203032)。

摘　　要：目的:分析CT灌注参数及血清转化生长因子β1(Transforming growth factor-β1,TGF-β1)水平对中晚期肝癌经导管动脉化疗栓塞(Transcatheter arterial chemoembolization,TACE)治疗预后的预测价值。方法:选取2021年4月至2023年7月我院中晚期肝癌患者为研究对象,根据患者治疗6 m后不同临床预后分为,预后良好及预后不良组;取中晚期肝癌患者的肝癌组织及至少15 mm处癌旁正常组织,进行相关检测,对比中晚期肝癌(入院时)及其不同预后患者(治疗前、后)CT灌注参数及血清TGF-β1水平,经采用接受者操作特性(Receiver operator characteristic,ROC)探讨其联合检测对预后不良的预测价值。结果:癌组织血流量(Blood flow,BF)、肝动脉灌注(Arterial liver perfusion,ALP)、肝动脉灌注指数(Hepatic perfusion index,HPI)及血清TGF-β1均高于癌旁组织,参数门静脉灌注(Portal liver perfusion,PVP)显著低于癌旁组织(P<0.05);预后不良患者治疗前、后参数BF、ALP、HPI及血清TGF-β1均高于预后良好患者,参数PVP显著低于预后良好患者(P<0.05);治疗前、后参数BF、ALP、HPI、PVP及TGF-β1水平联合检测对预测患者预后不良的曲线下面积(Area under the curve,AUC)为0.768、0.828。结论:CT灌注成像参数联合血清TGF-β1预测中晚期肝癌患者TACE治疗预后效能良好,可为临床诊疗提供参考。Objective:To analyze the predictive value of CT perfusion parameters and serum levels of transforming growth factor-β1(TGF-β1)for the prognosis of advanced liver cancer treated with transcatheter arterial chemoembolization(TACE).Methods:Patients with advanced liver cancer in our hospital from April 2021 to July 2023 were selected as the research subjects,and divided them into good and poor prognosis groups based on their clinical prognosis after 6 months of treatment;the liver cancer tissues and at least 15 mm of normal tissues adjacent to the cancer in patients with advanced liver cancer were taken for relevant testing.The CT perfusion parameters and serum TGF-β1 levels were compared between patients with advanced liver cancer(at admission)and patients with different prognoses(before and after treatment).The predictive value of combined detection for poor prognosis was explored using the receiver operator characteristic(ROC).Results:The blood flow(BF),arterial liver perfusion(ALP),hepatic perfusion index(HPI),and serum TGF-β1 levels in cancerous tissues are higher than those in the surrounding non-cancerous tissues.The portal vein perfusion(PVP)parameter is significantly lower than that in the surrounding non-cancerous tissues(P<0.05).Parameters BF,ALP,HPI and serum TGF-β1 in patients with poor prognosis were higher than those in patients with good prognosis before and after treatment,and parameters PVP were significantly lower than those in patients with good prognosis(P<0.05).The AUC of BF,ALP,HPI,PVP and TGF-β1 combined before and after treatment for predicting poor prognosis were 0.768 and 0.828.Conclusion:CT perfusion parameters combined with serum TGF-β1 can predict the prognosis of TACE treatment in patients with advanced liver cancer,which can provide reference for clinical diagnosis and treatment.

关 键 词：CT灌注参数 TGF-β1 中晚期肝癌 预后 

分 类 号：R735.7[医药卫生—肿瘤]