摘要
目的:探讨钆贝葡胺(Gd-BOPTA)多期增强MRI预测肝细胞癌(HCC)细胞角蛋白19(CK19)表达状态的价值。方法:回顾性分析2016年6月至2020年2月福建医科大学附属第一医院经病理和免疫组织化学检测的HCC患者153例,其中CK19阳性31例、CK19阴性122例。患者术前均行MRI平扫和Gd-BOPTA增强扫描。MRI征象定性观察指标包括肿瘤形态、马赛克征、肿瘤内出血、肿瘤内脂肪、非环状动脉期高强化、非周边廓清、靶环样表现、强化包膜、晕状强化、DWI信号、脉管侵犯和肝胆期强化方式;定量指标测量肝胆期的肿瘤-肝脏信号强度比(SR)。CK19阳性组与阴性组间定性资料比较采用χ2检验或Fisher确切概率法,定量资料采用独立样本t检验或Mann-Whitney U检验。采用多因素logistic回归筛选CK19阳性表达的独立预测因素。采用ROC曲线分析联合预测CK19阳性表达的效能。结果:CK19阳性组和阴性组间甲胎蛋白、肿瘤形态、非环状动脉期高强化、非周边廓清、靶环样强化、晕状强化、肝胆期强化方式和SR的差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示肿瘤形态、晕状强化、肝胆期强化方式和SR是HCC CK19阳性表达的独立预测因素。联合以上4个因素的模型预测HCC CK19阳性表达的AUC为0.823,灵敏度和特异度分别为80.7%和75.4%。结论:Gd-BOPTA多期增强MRI可有效评价HCC CK19表达状态,联合肝胆期征象能提高CK19的预测效能。
Objective To investigate the predictive value of gadobenate dimeglumine(GD-BOPTA)multi-phase enhanced MRI for the expression of cytokeratin19(CK19)in hepatocellular carcinoma(HCC).Methods A total of 153 patients of HCC confirmed by pathology from June 2016 to February 2020 in First Affiliated Hospital of Fujian Medical University were enrolled retrospectively.According to the post-operative pathology,the patients were divided into CK19-negative group(n=122)and CK19-positive group(n=31).All the patients underwent MRI scan and Gd-BOPTA multi-phase enhanced scan before operation.MRI features on Gd-BOPTA MRI were compared between two groups.The qualitative indicators included tumor morphology,mosaic signs,intratumoral hemorrhage,intratumoral fat,non-rim arterial phase hyper-enhancement(APHE),non-peripheral washout,targetoid manifestation,enhanced capsule,corona enhancement,DWI signal,vascular invasion and hepatobiliary phase(HBP)enhancement.The quantitative indicator of tumor-to-liver signal ratio(SR)on HBP was recorded.Theχ2 test or Fisher exact probability method was used to compare the qualitative parameters between two groups,and student′s t test or Mann-Whitney U test was used for quantitative data.Predictive parameters were identified by univariate and multivariate logistic regression analysis to predict the value of the expression of CK19.The ROC curve was used to analyze the diagnostic efficacy of MRI parameters.Results There were statistically significant differences between CK19-positive and CK19-negative groups(P<0.05)in alpha fetoprotein,tumor morphology,non-rim APHE,non-peripheral washout,targetoid manifestation,corona enhancement,HBP enhancement and SR.Multivariate logistic regression analysis showed tumor morphology,corona enhancement,HBP enhancement and SR were independent predictors of CK19 expression in HCC.The area under the ROC curve of the combined four indicators for predicting CK19 expression in HCC was 0.823,and the sensitivity and specificity were 80.7%and 75.4%,respectively.Conclusions Gd
作者
郑婉静
邢振
熊美连
林晓君
曹代荣
Zheng Wanjing;Xing Zhen;Xiong Meilian;Lin Xiaojun;Cao Dairong(Department of Radiology,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2021年第6期644-649,共6页
Chinese Journal of Radiology
基金
福建省教育厅中青年教师教育科研项目(JAT200167)。
关键词
癌
肝细胞
磁共振成像
钆贝葡胺
角蛋白19
Carcinoma,hepatocellular
Magnetic resonance imaging
Gadobenate dimeglumine
Keratin-19
