原发性肝癌患者B超检查指标与肝动脉栓塞术疗效及早期复发的相关性

Correlation between B-ultrasound and PHC hepatic artery embolization treatment and early recurrence

目的:分析原发性肝癌(PHC)患者B超检查指标与肝动脉栓塞术疗效及早期复发的相关性。方法:分析2012年4月至2014年7月在我院接受治疗的124例PHC患者的临床资料,记录患者年龄、性别、Child-Pugh分级、术前AFP、肿瘤直径、病灶个数等基础资料,所有患者均接受B超检查。根据入组患者预后情况分为预后不良组(A组)和预后良好组(B组)。应用受试者工作特征曲线(ROC)分析B超检查指标与PHC肝动脉栓塞术疗效及早期复发的相关性。结果:B组患者肝动脉内径、肝动脉收缩期峰值、肿瘤直径均高于A组,差异有统计学意义[(0.47±0.05)vs(0.40±0.04),(81.03±13.16)vs(73.03±10.16),(4.12±0.43)vs(3.98±0.39),均P<0.05]。肝动脉内径、肝动脉收缩期峰值和肿瘤直径等B超检查指标与PHC患者预后均呈现显著负相关(r=-0.571,-0.492,-0.411,均P<0.05)。B超对PHC患者早期复发的灵敏度、准确度、特异度分别为0.943、0.951、0.922。Kappa值为0.866,说明B超指标诊断早期复发与金标准具有较高的一致性。结论:B超检查指标可用于评估PHC患者肝动脉栓塞术的疗效,并可较好诊断PHC早期复发,具有较好的临床应用前景。

Objective: to analyze the correlation between B-ultrasound and PHC hepatic artery embolization treatment and early recurrence. Methods: Total of 124 patients with primary liver cancer who were treated in our hospital from April 2012 to July 2014 were retrospectively analyzed. The age,sex and Child-Pugh grade, preoperative AFP, tumor diameter and the number of lesions were recorded. All patients were examined by B-ultrasound. According to the prognosis of the patients, poor prognosis group(A group) and good prognosis group(B group). The correlation between B-rasonography and PHC hepatic artery embolization treatment and early recurrence were analyzed by using the operating characteristic curve(ROC). Results: the diameter of hepatic artery,the peak systolic phase of hepatic artery and the longitudinal diameter of mass in group B were significantly higher than those in group A[(0.47±0.05)vs(0.40±0.04),(81.03±13.16)vs(73.03±10.16),(4.12±0.43)vs(3.98±0.39),P<0.05]. It can be seen that the diameter of hepatic artery,the peak systolic phase of hepatic artery and the longitudinal diameter of mass were negatively correlated with the prognosis of PHC patients(P<0. 05). The sensitivity and accuracy of ultrasonography in early recurrence of PHC were found to be significantly negative(r=-0.571,-0.492,-0.411,P<0.05). The specificity was 0.943~0.951~0.922. Kappa=0.866 respectively, which indicated that the early recurrence diagnosis by B-ultrasound was in good agreement with the gold standardConclusion:B-ultrasonography can be used to evaluate the therapeutic effect of hepatic artery embolization in PHC and to diagnose early recurrence of liver cancer. It has a good prospect of clinical application.