循环肿瘤细胞、肝脏MRI平扫及DWI对HCC经TACE、微波消融治疗后的疗效判断价值分析  

The Application of MRI Plain Scan,DWI,and Examination of Circulating Tumor Cells and Liver in the Follow-up of HCC After TACE and Microwave Ablation Treatment

作　　者：郝凯 石俊英 陈勇 杨新焕 HAO Kai;SHI Junying;CHEN Yong(The Fifth Clinical School of Henan University of Traditional Chinese Medicine(Zhengzhou People's Hospital),Zhengzhou,450000)

机构地区：[1]河南中医药大学第五临床医学院,郑州人民医院,450000

出　　处：《实用癌症杂志》2025年第3期496-499,共4页The Practical Journal of Cancer

摘　　要：目的 探讨循环肿瘤细胞及肝脏磁共振成像(MRI)平扫、扩散加权成像(DWI)对原发性肝癌(HCC)经肝动脉化疗栓塞术(TACE)、微波消融治疗后的疗效判断。方法 选取HCC患者86例,共计有112个病灶;所有患者给予TACE、微波消融治疗,治疗3个月后,比较有无肿瘤生长病灶MRI平扫、DWI等差异。结果 有肿瘤生长者37例,无肿瘤生长者49例;112个病灶中,有肿瘤生长48个,无肿瘤生长64个。肿瘤生长病灶T2WI高信号比例为68.75%,高于无肿瘤生长病灶(P<0.05)。有肿瘤生长病灶DWI高信号比例为72.92%,高于无肿瘤生长病灶(P<0.05),而病灶表观扩散系数(ADC)值为(1.35±0.55)×10^(-3)mm^(2)/s,低于无肿瘤生长病灶(P<0.05)。有肿瘤生长患者循环肿瘤细胞数为(5.65±0.92)个,高于无肿瘤生长患者(P<0.05)。病灶T2WI高信号、病灶DWI高信号、病灶ADC值、循环肿瘤细胞数判断肿瘤生长的ROC曲线下面积分别为0.727、0.732、0.797和0.841。结论 循环肿瘤细胞及肝脏MRI平扫、DWI判断HCC经TACE、微波消融治疗效果有一定应用价值,值得临床使用。Objective To explore the efficacy evaluation of circulating tumor cells and liver magnetic resonance imaging(MRI)plain scan and diffusion-weighted imaging(DWI)for primary liver cancer(HCC)after hepatic artery chemoembolization(TACE)and microwave ablation treatment.Methods 86 patients with HCC were selected,with a total of 112 lesions;All patients were treated with TACE and microwave ablation.After 3 months of treatment,differences in tumor growth lesions were compared between MRI plain scan and DWI.Results There were 37 patients with tumor growth and 49 patients without tumor growth.Among 112 lesions,48 had tumor growth and 64 had no tumor growth.The proportion of high signal on T2WI of tumor growth lesions was 68.75%,which was higher than that of non tumor growth lesions(P<0.05).The high signal ratio of DWI with tumor growth lesions was 72.92%,which was higher than that without tumor growth lesions(P<0.05),and the apparent diffusion coefficient(ADC)value of lesions was(1.35±0.55)×10^(-3) mm^(2)/s,which was lower than no tumor growth lesions(P<0.05).The number of circulating tumor cells in patients with tumor growth was(5.65±0.92),which was higher than that in patients without tumor growth lesions(P<0.05).The areas under the ROC curve for diagnosing tumor growth by lesions with high signal intensity on T2WI,high signal intensity on DWI,ADC value,and circulating tumor cell count were 0.727,0.732,0.797,and 0.841,respectively.Conclusion Circulating tumor cells and liver MRI plain scan,DWI,and enhancement have certain application value in evaluating the therapeutic effect of HCC,and are worthy of clinical use.

关 键 词：循环肿瘤细胞 磁共振成像 扩散加权成像 原发性肝癌 肝动脉化疗栓塞术 微波消融 

分 类 号：R735.7[医药卫生—肿瘤]