| 摘要: |
| 目的：探讨超声造影参数鉴别胆管细胞癌与肝细胞癌的价值及其与MVD的关系。方法：回顾性分析经病理确诊的42例胆管细胞癌患者与114例肝细胞癌患者的临床资料。研究时间为2015年05月至2019年08月,肝细胞癌患者按照不同分化程度分为高分化组、中分化组、低分化组,各38例；予以超声造影与免疫组化方法检测,评估检测后始增时间、峰值时间、始退时间、持续时间、微血管定量(MVD),分析超声造影定量灌注参数与MVD的关系,以及ROC曲线。结果：胆管细胞癌组的始增时间、峰值强度高于高、中、低分化组(P＜0.05)；胆管细胞癌组的峰值时间与高分化、中分化组相比,差异无统计学意义(P＞0.05)；胆管细胞癌组的峰值时间高于低分化组(P＜0.05)；胆管细胞癌组的始退时间、持续时间、MVD低于高、中、低分化组(P＜0.05)。胆管细胞癌组的始增强度与高、中、低分化组相比,差异无统计学意义(P＞0.05)。相关性分析显示,始增时间、始退时间与MVD无相关性(P＞0.05)；峰值时间、峰值强度与MVD呈负相关(P＜0.05)；持续时间、始增强度与MVD呈正相关(P＜0.05)。ROC曲线分析显示,始增时间的曲线下面积AUC值为(0.695,P＜0.05)；峰值时间的曲线下面积AUC值为(0.779,P＜0.05)；始退时间的曲线下面积AUC值为(0.655,P＜0.05)；持续时间的曲线下面积AUC值为(0.624,P＜0.05)；始增强度的曲线下面积AUC值为(0.635,P＜0.05)；峰值强度的曲线下面积AUC值为(0.639,P＜0.05)；MVD的曲线下面积AUC值为(0.998,P＜0.05)。结论：超声造影能够鉴别胆管细胞癌与肝细胞癌,通过时间-强度曲线各定量参数值评估肿瘤的分化程度,以及反映肿瘤内新生血管,能为其治疗提供客观依据。 |
| 关键词: 胆管细胞癌 分化 肝细胞癌 超声造影 微血管定量 |
| DOI： |
| 投稿时间：2020-12-22修订日期：2020-12-22 |
| 基金项目: |
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| The value of contrast-enhanced ultrasound parameters in distinguishing cholangiocarcinoma from hepatocellular carcinoma and its relationship with MVD |
| Hong Dena,Zhu Guixin,Zhang Jinghong,Li Bing |
| () |
| Abstract: |
| Objective: To explore the value of contrast-enhanced ultrasound parameters in distinguishing cholangiocarcinoma from hepatocellular carcinoma and its relationship with MVD. Methods: The clinical data of 42 patients with cholangiocarcinoma and 114 patients with hepatocellular carcinoma diagnosed by pathology were retrospectively analyzed. The study period was from May 2015 to August 2019. Patients with hepatocellular carcinoma were divided into well-differentiated group, moderately-differentiated group, and poorly-differentiated group according to different degrees of differentiation, with 38 cases in each group; they were tested and evaluated by contrast-enhanced ultrasound and immunohistochemistry After detection, the initial increase time, peak time, initial retreat time, duration, microvascular quantification (MVD), analysis of the relationship between quantitative ultrasound perfusion parameters and MVD, and ROC curve.Results: The initial growth time and peak intensity of cholangiocarcinoma group were higher than those of high, medium and poorly differentiated groups (P＜0.05);There was no statistically significant difference in the peak time of cholangiocarcinoma group compared with the well differentiated and moderately differentiated groups (P>0.05);The peak time of cholangiocarcinoma group was higher than that of poorly differentiated group (P＜0.05);The initial regression time, duration, and MVD of the cholangiocarcinoma group were lower than those of the high, medium and poorly differentiated groups (P<0.05).There was no statistically significant difference in the initial enhancement of cholangiocarcinoma group and high, medium and poorly differentiated group (P>0.05).Correlation analysis showed that the initial increase time and initial retreat time were not correlated with MVD (P>0.05); peak time and peak intensity were negatively correlated with MVD (P<0.05); duration and initial enhancement were positively correlated with MVD ( P<0.05).ROC curve analysis showed that the AUC value of the area under the curve of the initial increase time was (0.695, P＜0.05); the AUC value of the area under the curve of the peak time was (0.779, P＜0.05); the AUC value of the area under the curve of the initial increase (0.655, P＜0.05); the AUC value of the area under the curve of duration is (0.624, P＜0.05); the AUC value of the area under the curve of initial enhancement is (0.635, P＜0.05); the area under the curve of peak intensity AUC The value is (0.639, P<0.05); the AUC value of the area under the curve of MVD is (0.998, P<0.05).Conclusion: Contrast-enhanced ultrasound can distinguish cholangiocarcinoma from hepatocellular carcinoma, evaluate the differentiation degree of the tumor through the quantitative parameter values of the time-intensity curve, and reflect the neovascularization in the tumor, which can provide an objective basis for its treatment. |
| Key words: Cholangiocarcinoma Differentiation Hepatocellular carcinoma Contrast ultrasound Microvascular density |
