CT增强纹理技术对TACE治疗的原发性肝癌患者术后肿瘤短期进展的预测价值

Clinical value of enhanced CT texture analysis technique in predicting short-term recurrence of liver tumor in patients with HCC after TACE

目的研究CT增强纹理分析技术对经导管肝动脉化疗栓塞术(TACE)治疗的原发性肝癌(PLC)患者短期进展风险的预测价值。方法2016年11月~2019年11月我院收治的70例PLC患者,接受TACE治疗和上腹部CT增强检查随访。运用CT增强纹理技术分析CT轴位增强图像,勾画肿瘤边界,逐层获取两组纹理分析均数、熵值、偏度、峰度和不均匀度。应用受试者工作特征(ROC)曲线下面积(AUC)分析上述纹理参数对TACE术后患者短期肿瘤进展风险。结果本组在TACE治疗后6个月内肿瘤局灶性进展40例,无局灶性进展30例;局灶性进展组CT均数为20553.8±4094.5,显著低于无进展组(23407.3±4634.3,P<0.05);局灶性进展组熵值和不均匀度分别为4.2±0.3和0.26±0.12,显著高于B组【分别为(3.8±0.2)和(0.18±0.08),P<0.05】,而两组偏度和峰度比较差异无统计学意义(P>0.05);经ROC曲线分析,结果显示肿瘤CT均数、熵值和不均匀度预测TACE术后短期肿瘤进展风险均有一定的价值,其AUC分别为0.785、0.694和0.761。结论CT增强纹理分析技术对经TACE术治疗的PLC患者肿瘤短期进展风险具有重要的预测价值,临床可考虑应用。

Objective The aim of this study was to investigate the clinical value of enhanced CT texture analysis technique in predicting short-term recurrence of liver tumor in patients with hepatocellular carcinoma(HCC)aftertranscatheter arterial chemoembolization(TACE).Methods 70 patients with unresectable HCC were recruited between November 2016 and November 2019,and all of them received TACE and enhanced CT scanning for follow-up.The tumor boundary was drawn layer by layer on the enhanced CT axial image by texture analysis technology,and the mean,entropy,skewness,kurtosis,and nonuniformity were obtained.The area under the receiver operating characteristic(ROC)curve(AUROC)was applied to analyze the predictive value of the above texture analysis parameters for the risk of short-term recurrence of tumors after TACE.Results The tumor showed short-term recurrence in 40 cases,and non-short-term recurrence in 30 cases in our series;the mean of CT texture in patients with short-term tumor recurrence was 20553.8±4094.5,significantly lower than(23407.3±4634.3,P<0.05)in patients without;the entropy and unevenness were 4.2±0.3 and 0.26±0.12,significantly higher than[(3.8±0.2)and(0.18±0.08),respectively,P<0.05]in patients without,while there were no significant differences in skewness and kurtosis between the two groups(P>0.05);the ROC curve analysis showed that the mean,entropy and nonuniformity had certain predictive value for the risk of short-term tumor recurrence after TACE,with the AUC of 0.785,0.694 and 0.761,respectively.Conclusion The enhanced CT texture analysis technique has an important predictive value for the risk of short-term tumor recurrence in patients with HCC after TACE,which needs further investigation.