| 摘要: |
| 目的 探讨超声造影（CEUS）定量参数联合血清甲胎蛋白（AFP）、异常凝血酶原（PIVKA-Ⅱ）、α-L-岩藻糖苷酶（AFU)对于肝硬化肝癌早期诊断的价值。方法 选取从2018年7月至2021年3月期间，在我院确诊为肝硬化肝癌患者156例作为肝癌组，及同期在我院体检的健康志愿者共70人作为正常对照组。对比两组的CEUS定量参数[增强时间（ET）、达峰时间（TTP）、廓清时间（WT）、峰值强度（PI）]水平，以及血清标志物AFP、PIVKA-Ⅱ、AFU的水平差异。用ROC曲线评估CEUS定量参数ET、TTP、WT和PI及血清标志物AFP、PIVKA-Ⅱ、AFU单独和联合检测用于肝硬化肝癌的诊断效能。结果 肝癌组患者的ET、TTP及WT值短于正常对照组，PI值高于正常对照组，差异有统计学意义(P＜0.05)。肝癌组AFP、PIVKA- Ⅱ和AFU水平高于正常对照组，两组间差异具有统计学意义（P＜0.05）。各指标单独检测用于诊断肝硬化肝癌时，PIVKA-Ⅱ的敏感性、阳性检测率及AUC值最高，联合诊断时ET+TTP+WT+PI+AFP+PIVKA-Ⅱ+AFU7者联合检测的敏感性、特异性、阳性预测率和阴性预测率均为最高，差异均具有统计学意义（P＜0.05）。结论 CEUS定量参数与血清AFP、PIVKA-Ⅱ、AFU联合检测对于肝硬化肝癌早期诊断具有重要价值。 |
| 关键词: 肝硬化肝癌 超声造影 AFP PIVKA-Ⅱ AFU 诊断价值 |
| DOI： |
| 投稿时间：2021-09-17修订日期：2021-09-17 |
| 基金项目:四川省医学科研课题计划项目（Q18005） |
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| Value of contrast-enhanced ultrasonography and quantitative parameters combined with blood biochemical indexes in early diagnosis of liver cancer with cirrhosis |
| Zhou Cheng-xiang |
| () |
| Abstract: |
| Objective To explore the value of quantitative parameters from contrast-enhanced ultrasound(CEUS) combined with alpha-fetoprotein (AFP)、protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ )、α-L-fucosidase (AFU) from serum in the early diagnosis of liver cancer with cirrhosis. Methods From July 2018 to March 2021, 156 patients diagnosed with liver cirrhosis in our hospital were selected as the liver cancer group, and a total of 70 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the normal control group. Quantitative parameters of CEUS [enhancement time(ET),time to peak(TTP), washtime(WT),peak intensity (PI)] and serum markers(AFP、PIVKA-Ⅱ、AFU)were compared between the two groups. ROC curve was used to evaluate the diagnostic efficacy of CEUS quantitative parameters ET,TTP,WT and PI and serum markers AFP、PIVKA-Ⅱand AFU alone and in combination for liver cancer with cirrhosis. Results The value of ET,TTP,WT of hepatocellular carcinoma group was shorter than that of normal control group, and the PI value was higher than that of normal control group. The difference had statistical sense（P＜0.05）.The levels of AFP, PIVKA-Ⅱ and AFU in hepatocellular carcinoma group were higher than those in normal control group. Difference between the two groups had statistical significance(P＜0.05).The sensitivity,positive prediction rate and AUC value of PIVKA-Ⅱ were the highest when each index was detected separately for the diagnosis of liver cancer with cirrhosis. The sensitivity, specificity, positive prediction rate and negative prediction rate of ET+TTP+WT+PI+AFP+ PIVKA-Ⅱ +AFU were the highest in combined diagnosis.The differences were statistically significant(P＜0.05).Conclusion The combination of quantitative parameters of CEUS with AFP, PIVKA-Ⅱ and AFU of serum is of great value for the early diagnosis of liver cancer with cirrhosis. |
| Key words: Liver cancer with cirrhosis CEUS AFP PIVKA-Ⅱ AFU Diagnostic value |
