摘要
目的探讨血清标志物和影像参数在肝细胞癌(Hepatocellular carcinoma,HCC)患者肝脏纤维化程度术前无创评估中的价值。方法纳入28名HCC患者,依据肝脏纤维化程度,将患者分为低级别纤维化组(Grade 1组,纤维化程度S0-S2)和高级别纤维化组(Grade 2组,纤维化程度S3-S4)。获取患者术前血清标志物:白蛋白/球蛋白、白蛋白(ALB)、中性粒细胞/淋巴细胞、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、谷氨酰转肽酶(GGT)、血小板计数(PLT)、APRI、S指数、FIB-4分数。利用术前CT或磁共振扫描图像,计数得到相应肝段体积。采用Mann-Whitney U检验对Grade 1组和Grade 2组血清标志物及影像参数的差异进行比较。采用受试者工作特征曲线下面积(area under the ROC curve,AUC)评估血清标志物及影像参数对Grade 2组肝脏纤维化的诊断效能。结果Grade 2组患者的PLT显著小于Grade 1组,而Grade 2组患者的S指数和FIB-4分数显著大于Grade 1组(P均<0.05)。FIB-4分数对Grade 2组肝脏纤维化具有最高诊断效能(AUC=0.805),其次为PLT(AUC=0.751)和S指数(AUC=0.728)。结论PLT、S指数及FIB-4分数对HCC患者术前肝纤维化程度具有较好的诊断价值,这将有利于HCC患者术前肝脏纤维化程度的无创评估。
Objective To investigate the value of serum markers combined with imaging parameters in the preoperative noninvasive assessment of the degree of liver fibrosis in patients with Hepatocellular carcinoma(HCC).Methods 28 HCC patients were selected.According to the degree of liver fibrosis,patients were divided into low-grade fibrosis group(Grade 1 group;fibrosis degree,S0-S2)and high-grade fibrosis group(Grade 2 group;fibrosis degree,S3-S4).Preoperative serum markers were obtained:albumin/globulin,albumin(ALB),neutrophil/lymphocyte,aspartate aminotransferase(AST),alanine aminotransferase(ALT),gamma-glutamyl transferase(GGT),platelet(PLT),APRI,S index,and FIB-4 score.Preoperative CT or magnetic resonance imaging images were used to calculate the corresponding segment liver volume.Mann-Whitney U test was used to compare the differences of serum markers and imaging parameters between the two groups.Area under the ROC curve(AUC)was used to evaluate the diagnostic efficacy of serum markers and imaging parameters for liver fibrosis in Grade 2 group.Results The PLT of patients in Grade 2 group was significantly lower than that in Grade 1 group,while the S index and FIB-4 score of patients in Grade 2 group were significantly higher than those in Grade 1 group(AllP<0.05).FIB-4 score had the highest diagnostic efficiency for liver fibrosis in Grade 2 group(AUC=0.805),followed by PLT(AUC=0.751)and S index(AUC=0.728).Conclusion PLT,S index and FIB-4 score have good diagnostic value for preoperative liver fibrosis degree in patients with HCC,which will be conducive to the non-invasive evaluation of preoperative liver fibrosis degree in patientswith HCC.
作者
史志浩
周楠
魏晓磊
梁静
张冰
仇毓东
陈骏
唐敏
SHI Zhi-hao;ZHOU Nan;WEI Xiao-lei(Department of Medical Imaging,Department of Hepatopancreatobiliary surgery,Department of Pathology,the Affiliated DrumTower Hospital of Nanjing University Medical School,Nanjing 210008,China)
出处
《肝胆外科杂志》
2021年第1期24-27,共4页
Journal of Hepatobiliary Surgery
关键词
肝细胞癌
肝脏纤维化
血清标志物
影像参数
无创定量评估
hepatocellular carcinoma
liver fibrosis
serum markers
imaging parameters
noninvasive quantitative evaluation
