拉曼光谱技术在原发性肝癌与肝硬化组织鉴别中的应用价值  

Application value of Raman spectroscopy in the differential diagnosis of primary liver cancer and liver cirrhosis

作　　者：孙睿 席跃 沈阳洋 李胜 SUN Rui;XI Yue;SHEN Yangyang;LI Sheng(Clinical and Basic Medical College,Shandong First Medical University(Shandong Academy of Medical Sciences),Jinan 250117,China)

机构地区：[1]山东第一医科大学(山东省医学科学院)临床与基础医学院,山东济南250117 [2]山东省肿瘤医院(山东省肿瘤防治研究院)肝胆外科,山东济南250117 [3]山东省肿瘤医院(山东省肿瘤防治研究院)麻醉科,山东济南250117 [4]山东第一医科大学第二附属医院普外科,山东泰安271000

出　　处：《山东医药》2025年第1期34-37,共4页Shandong Medical Journal

基　　金：山东省济南市新高校20条资助项目(2021GXRC060)。

摘　　要：目的探讨拉曼光谱技术在原发性肝癌与肝硬化组织鉴别中的有效性,为肝癌手术中确定安全的手术切缘距离提供新方法。方法收集原发性肝癌合并肝硬化患者肝癌组织和癌旁肝硬化组织各30例,使用显微共聚焦拉曼光谱仪进行拉曼光谱分析。比较原发性肝癌组织与肝硬化组织拉曼光谱峰位的峰强,绘制受试者工作特征(ROC)曲线评估拉曼光谱技术在原发性肝癌与肝硬化组织鉴别中的应用价值。结果拉曼光谱分析显示,在1004 cm^(-1)、1155 cm^(-1)、1510 cm^(-1)拉曼峰位附近,原发性肝癌组织拉曼峰强低于肝硬化组织;在1642 cm^(-1)处拉曼峰位附近,原发性肝癌组织的峰强高于肝硬化组织(P均<0.05)。在1377 cm^(-1)和1586 cm^(-1)拉曼峰位附近可观察到原发性肝癌组织所特有的显著特征峰强,而肝硬化组织则未出现。ROC曲线分析结果显示,在1004 cm^(-1)、1155 cm^(-1)、1510 cm^(-1)、1642 cm^(-1)峰位附近,拉曼光谱鉴别原发性肝癌及肝硬化组织的ROC曲线下面积均为1,对应的最佳临界值分别为248.5、531.0、773.5、249.5 counts,灵敏度、特异度均为100%(P均<0.05)。结论拉曼光谱技术在1004 cm^(-1)、1155 cm^(-1)、1510 cm^(-1)和1642 cm^(-1)等关键峰位附近可有效鉴别肝癌组织与癌旁肝硬化肝组织,具有潜在的临床应用价值。Objective To investigate the efficacy of Raman spectroscopy in the identification of primary liver cancer and liver cirrhosis,and to provide a novel approach for determining the safe surgical margin distance in liver cancer surgeries.Methods Thirty samples of liver cancer tissues and 30 cases of para-cancerous cirrhotic tissues were collected from patients with primary liver cancer complicated by liver cirrhosis.Raman spectroscopy analysis was performed using a microscopic confocal Raman spectrometer.The peak intensities of the Raman spectra at various positions in primary liver cancer tissues were compared with those in cirrhotic tissues,and a receiver operating characteristic(ROC)curve was drawn to evaluate the application value of Raman spectroscopy in distinguishing primary liver cancer and cirrhotic tissues.Results Raman spectrum analysis demonstrated that the intensity of Raman peaks in primary liver cancer tissues was significantly lower than that in cirrhosis tissues at the Raman peaks of 1,004,1,155,and 1,510 cm^(-1).In contrast,at the Raman peak of 1,642 cm^(-1),the peak intensity for primary liver cancer tissues surpassed that of cirrhosis tissues(all P<0.05).Notably,significant characteristic peaks specific to primary liver cancer tissues were identified near the Raman peaks at 1,377 and 1,586 cm^(-1),while these peaks were not present in cirrhosis tissues.The results of ROC curve analysis indicated that the area under the ROC curve of Raman spectroscopy in differentiating primary liver cancer and cirrhosis was equal to 1 at the peaks of 1,004,1,155,1,510,and 1,642 cm^(-1).The corresponding optimal critical values were 248.5,531.0,773.5,and 249.5 counts,respectively.Both the sensitivity and specificity were 100%(all P<0.05).Conclusion Raman spectroscopy can effectively identify liver cancer tissues and para-cancerous cirrhotic liver tissues near the key peaks of 1,004,1,155,1,510,and 1,642 cm^(-1),and has potential clinical application value.

关 键 词：拉曼光谱技术 原发性肝癌 肝硬化 手术切缘 

分 类 号：R615[医药卫生—外科学]