MRI减影技术评估系统治疗中晚期肝细胞癌效果、预测联合手术治疗后预后  

MRI subtraction technique for evaluating efficacy of systemic therapy for advanced hepatocellular carcinoma and predicting prognosis after combining with surgery

作　　者：向涛 袁冰 李晓辉 董景辉 朱震宇 刘定坤 杨健[5] 艾丹妮 刘江涛 段峰 XIANG Tao;YUAN Bing;LI Xiaohui;DONG Jinghui;ZHU Zhenyu;LIU Dingkun;YANG Jian;AI Danni;LIU Jiangtao;DUAN Feng(Department of Radiology,the First Medical Center of PLA General Hospital,Beijing 100853,China;Senior Department of Oncology,the Fifth Medical Center of PLA General Hospital,Beijing 100039,China;Department of Radiology,the Fifth Medical Center of PLA General Hospital,Beijing 100039,China;Department of Hepatology,the Fifth Medical Center of PLA General Hospital,Beijing 100039,China;School of Optics and Photonics,Beijing Institute of Technology,Beijing 100081,China;Department of Gastroenterology,Hainan Hospital of PLA General Hospital,Sanya 572022,China)

机构地区：[1]中国人民解放军总医院第一医学中心放射科,北京100853 [2]中国人民解放军总医院第五医学中心肿瘤医学部,北京100039 [3]中国人民解放军总医院第五医学中心放射科,北京100039 [4]中国人民解放军总医院第五医学中心肝胆外科,北京100039 [5]北京理工大学光电学院,北京100081 [6]中国人民解放军总医院海南分院消化内科,海南三亚572022

出　　处：《中国介入影像与治疗学》2025年第3期210-215,共6页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家自然科学项目(82172037)。

摘　　要：目的观察MRI减影技术(ST)评估系统治疗中晚期肝细胞癌(HCC)效果及预测联合手术治疗后预后的价值。方法回顾性收集接受系统治疗+根治性切除术的35例中晚期HCC共39个病灶。基于术前MRI以ST获得肿瘤活性比(记为肿瘤活性ST),通过术后病理获得肿瘤活性值(记为肿瘤活性病理),分析二者相关性。术后规律随访,记录患者生存资料;绘制受试者工作特征(ROC)曲线,评估以肿瘤活性ST预测患者生存状态的效能,根据最佳截断值划分生存获益组与无生存获益组并进行生存分析。结果肿瘤活性ST与肿瘤活性病理呈正相关(r=0.900,P<0.001)。8例于中位数为32.93个月的随访期间死亡,中位生存时间为29.9个月。肿瘤活性ST的曲线下面积(AUC)为0.67,最佳截断值为0.36,故将30例肿瘤活性ST<0.36者纳入生存获益组、5例≥0.36者归为无生存获益组。生存获益组总生存期长于无生存获益组(P<0.001)。结论MRI ST可用于无创评估中晚期HCC系统治疗效果及预测联合手术治疗后预后。Objective To explore the value of MRI subtraction technique(ST)for evaluating the efficacy of systemic therapy for advanced hepatocellular carcinoma(HCC)and predicting prognosis after combining with surgery.Methods Totally 35 patients with 39 HCC lesions who received systemic therapy+radical resection were retrospectively collected.Based on preoperative MRI,tumor activity ratio(recorded as tumor activityST)was obtained with ST,while tumor activity value(recorded as tumor activitypathology)was obtained through postoperative pathology,and their correlation was analyzed.The patients were regularly followed up after surgery,and the survival data were recorded.Receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of tumor activityST for predicting patients’survival status.Then the patients were divided into survival benefit group and no survival benefit group according to the cut-off value,and survival analysis was conducted.Results Tumor activityST was positively correlated with tumor activitypathology(r=0.900,P<0.001).The median follow-up time was 32.93 months,during which 8 patients died,and the median survival time was 29.9 months.The area under the curve(AUC)of tumor activityST for predicting patients’survival status was 0.67,and the cut-off value was 0.36.Thirty patients with tumor activityST<0.36 were enrolled in survival benefit group,while 5 patients≥0.36 were collected in no survival benefit group.The overall survival in survival benefit group was longer than that in no survival benefit group(P<0.001).Conclusion MRI ST could be used to non-invasively evaluate the efficacy of systemic therapy for advanced HCC and predict prognosis after combining with surgery.

关 键 词：癌 肝细胞 免疫治疗 分子靶向治疗 减影技术 治疗转归 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]