MSCT增强扫描对肝细胞癌患者介入治疗后复发的预测价值分析  

Predictive value of MSCT enhancement scan in recurrence of hepatocellular carcinoma patients after interventional therapy

作　　者：周舟[1] 史东星 周纪亮 ZHOU Zhou;SHI Dong-xing;ZHOU Ji-liang(Department of Radiology,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;Department of Imaging Medicine and Nuclear Medicine,Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院放射科,河南郑州450000 [2]河南中医药大学影像医学与核医学系,河南郑州450000

出　　处：《中国临床医学影像杂志》2024年第12期846-850,共5页Journal of China Clinic Medical Imaging

基　　金：2022年河南省卫生健康委国家中医临床研究科研项目(2022JDZX063、2022JDZX064)。

摘　　要：目的:探讨多层螺旋CT(MSCT)增强扫描对肝细胞癌(HCC)患者介入治疗后复发的预测价值。方法:选取2019年6月—2023年3月在我院接受介入治疗的102例HCC患者的临床资料进行研究。所有患者治疗前均接受MSCT增强扫描检查。治疗后随访1年统计复发率,根据复发统计结果,将患者分为复发组与未复发组,使用单因素分析及多因素Logistic回归分析HCC患者介入治疗后复发的影响因素。构建受试者工作特征(ROC)曲线分析MSCT增强扫描对HCC患者介入治疗后复发的预测价值。结果:102例HCC患者介入治疗后随访1年共复发37例,1年复发率为36.27%。根据随访1年是否复发分为复发组(n=37)与未复发组(n=65)。两组患者肿瘤直径、瘤体位置、动脉期增强率、静脉期增强率、年龄、性别、乙肝史、是否合并肝硬化、甲胎蛋白(AFP)、谷丙转氨酶(ALT)、总胆红素(TBiL)、白蛋白(ALB)比较无显著差异(P>0.05),两组患者强化征、肿瘤形态、包膜类型、天门冬氨酸转氨酶(AST)比较有显著差异(P<0.05)。Logistic回归分析显示,术前MSCT增强扫描有强化征、呈连续多结节形态、无包膜是HCC患者介入治疗后随访1年复发的独立危险因素(P<0.05)。ROC曲线分析结果显示,强化征、肿瘤形态、包膜类型预测HCC患者介入治疗后1年复发的曲线下面积(AUC)、敏感度、特异度分别为0.601、64.86%、55.38%,0.644、51.35%、75.38%,0.725、81.08%、53.85%(P<0.05)。结论:术前MSCT增强扫描有强化征、呈连续多结节形态、无包膜是HCC患者介入治疗后随访1年复发的独立危险因素,MSCT增强扫描预测HCC患者介入治疗后复发具有一定参考价值。Objective:To explore the predictive value of multi-slice spiral CT(MSCT)enhancement scan in recurrence of hepatocellular carcinoma(HCC)after interventional therapy.Methods:The clinical data were collected from 102 patients with HCC who underwent interventional therapy in the hospital between June 2019 and March 2023.All patients underwent MSCT enhancement scan before treatment.According to the recurrence by 1 year of follow-up after treatment,patients were divided into recurrence group and non-recurrence group.The influencing factors of recurrence in HCC patients after interventional therapy were analyzed by univariate analysis and multivariate Logistic regression analysis.The predictive value of MSCT enhancement scan in recurrence of HCC patients after interventional therapy was analyzed by receiver operating characteristic(ROC)curves.Results:In the 102 HCC patients after interventional therapy,there were 37 cases(36.27%)with recurrence within 1 year of follow-up.According to the recurrence by 1 year of follow-up,patients were divided into recurrence group(n=37)and non-recurrence group(n=65).There was no significant difference in tumor diameter,tumor sites,enhancement rates in arterial and venous phases,age,gender,history of hepatitis B,crrhosis,AFP,ALT,TBiL and ALB between the two groups(P>0.05),but there were significant differences in enhancement sign,tumor morphology,envelope types and AST(P<0.05).Logistic regression analysis showed that preoperative enhancement sign in MSCT enhancement scan,continuous multinodular morphology and no envelope were independent risk factors of recurrence in HCC patients(P<0.05).The results of ROC curves analysis showed that area under the curve(AUC),sensitivity and specificity of enhancement sign,tumor morphology and envelope type for predicting the recurrence in HCC patients at 1 year after interventional therapy were 0.601,64.86%,55.38%;0.644,51.35%,75.38%;0.725,81.08%,53.85%,respectively(P<0.05).Conclusion:Preoperative enhancement sign in MSCT enhancement scan,continuous mul

关 键 词：癌 肝细胞 复发 放射学 介入性 体层摄影术 螺旋计算机 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学] R815