普美显-磁共振动态增强扫描诊断胆管细胞型肝癌及对免疫特征的诊断效能的研究  

Diagnostic Efficacy Study of Primovis Dynamic Contrast-Enhanced Magnetic Resonance Imaging(MRI)for Intrahepatic Cholangiocarcinoma and Its Immune Features

作　　者：辛志业 谭键彬 吴嘉勇 XIN Zhiye;TAN Jianbin;WU Jiayong(Dongguan Binhai Bay Central Hospital,Dongguan,Guangdong 523900)

机构地区：[1]东莞市滨海湾中心医院,广东东莞523900

出　　处：《智慧健康》2024年第35期1-4,共4页Smart Healthcare

基　　金：东莞市社会科技发展面上项目《普美显-磁共振动态增强扫描诊断胆管细胞型肝癌及对免疫特征的诊断效能研究》(项目编号:20221800904252)。

摘　　要：目的探讨普美显-磁共振动态增强扫描诊断胆管细胞型肝癌(ICC)对免疫特征的诊断效能。方法回顾性分析了经手术病理证实的40例ICC和40例肝细胞癌(HCC)的资料,对这些病例进行MRI检查,并对ICC进行免疫组化分析。对影像检查结果进行分析,探讨影像特征与肿瘤之间的关系及其与免疫组织化学的相关性。结果多因素回归分析结果显示,动脉期和门静脉期的点/带状内部强化、血管侵入是ICC的主要影响因素,门静脉期和延迟期的渐进性强化、肝细胞期的靶征为ICC的保护因素。普美显-磁共振动态增强扫描检查ICC,其中动脉期环形强化影像特征的诊断灵敏度最高(88.14%),动脉期和门静脉期的点/带状内部强化影像特征的准确度最高(89.26%)。动脉期和门静脉期的点/带状内部强化与Hepatocyte、Glypican3、CD117呈负相关,动脉期环形强化与Hepatocyte、Glypican3、CK7、CD117呈负相关,门静脉期和延迟期的渐进性强化与Glypican3、CD117呈负相关,肝细胞期的靶征与Hepatocyte、Glypican3、CK19、CK7、CD117呈负相关,血管侵入与Hepatocyte、Glypican3、CK7、CD117呈负相关。结论普美显-磁共振动态增强扫描在诊断ICC中具有重要价值,影像特征与免疫组化标志物的负相关性验证了其在ICC诊断和预后评估中的潜在应用价值。Objective To explore diagnostic effect of Primovis dynamic contrast-enhanced magnetic resonance imaging(MRI)for immune features in diagnosis of intrahepatic cholangiocarcinoma(ICC).Methods The paper reviewed and analyzed data of 40 cases of ICC and 40 cases of hepatocellular carcinoma(HCC)confirmed by surgical pathology,carried out MRI examination and ICC immunohistochemical analysis,analyzed the imaging results,relationship between imaging features and tumors,and correlation with immunohistochemistry.Results Multiple regression analysis showed,point/band internal enhancement and vascular invasion in arterial and portal phases were main influencing factors of ICC.Progressive enhancement at portal and delayed phases,target signs at liver cell phase were protective factors of ICC.Dynamic contrast-enhanced MRI scan for ICC showed,circular enhancement imaging features at arterial phase had the highest diagnostic sensitivity(88.14%),point/band internal enhancement imaging features at the arterial and portal venous phases had the highest accuracy(89.26%).Point/band internal enhancement at arterial and portal venous phases was negatively correlated with Hepatocyte,Glypican3 and CD117,while circular enhancement at arterial phase was negatively correlated with Hepatocyte,Glypican3,CK7 and CD117.Progressive enhancement at portal venous phase and delayed phase was negatively correlated with Glypican3 and CD117.Target signs at hepatic cell phase were negatively correlated with Hepatocyte,Glypican3,CK19,CK7 and CD117,and vascular invasion was negatively correlated with Hepatocyte,Glypican3,CK7 and CD117.Conclusion Primovis dynamic contrast-enhanced magnetic resonance imaging(MRI)has important value in diagnosis of intrahepatic cholangiocarcinoma(ICC),and negative correlation between imaging features and immunohistochemical markers confirms its potential application value in diagnosis and prognosis evaluation of ICC.

关 键 词：胆管细胞型肝癌 肝细胞癌 普美显-磁共振动态增强扫描 免疫特征 诊断效能 

分 类 号：R73[医药卫生—肿瘤]