超声造影、血清AFP、CEA水平对肝癌介入术后微血管侵犯、早期复发的预测价值

Predictive Value of Contrast-enhanced Ultrasonography,Serum AFP and CEA Levels in Microvascular Invasion and Early Recurrence after Intervention Surgery of Liver Cancer

目的探讨超声造影(CEUS)、血清甲胎蛋白(AFP)、癌胚抗原(CEA)水平对肝癌介入术后微血管侵犯(MVI)、早期复发的预测价值。方法选择102例肝癌患者作为研究对象,分析CEUS、血清AFP、CEA对肝癌介入术后MVI、早期复发的预测价值。结果102例肝癌患者术后经病理分析,证实为MVI的有66例,非MVI的有36例。单因素分析显示,MVI组患者中多发肿瘤、无或不完整包膜、肿瘤边缘不光滑、门脉期快速消退的发生率均高于Non-MVI组;血清AFP、CEA水平高于Non-MVI组患者(P<0.05);多因素Logisitic回归分析发现多发肿瘤、包膜无或不完整是影响肝癌介入术后MVI独立危险因素。经术后1年的随访,102例肝癌患者证实为早期复发有21例;单因素分析显示,复发组患者中多发肿瘤、无或不完整包膜、门脉期快速消退、肿瘤内部坏死、MVI的发生率均高于未复发组;血清AFP、CEA水平均高于未复发组患者(P<0.05);多因素Logisitic回归分析发现存在MVI、包膜无或不完整是影响术后早期复发独立危险因素。结论CEUS检查中出现肿瘤多发、无或不完整包膜的肝癌患者术后出现MVI的风险更大;无或不完整包膜、合并MVI的肝癌患者术后早期复发的可能性更高,而血清AFP、CEA对肝癌介入术后MVI、早期复发的预测价值有待进一步探讨。

Objective To explore the predictive value of contrast-enhanced ultrasonography(CEUS),serum alpha-fetoprotein(AFP)and carcinoembryonic antigen(CEA)levels in microvascular invasion(MVI)and early recurrence after intervention surgery of liver cancer.Methods 102 patients with liver cancer were enrolled as the research objects.The predictive value of CEUS,serum AFP and CEA for MVI and early recurrence after intervention surgery of liver cancer was analyzed.Results In the 102 patients with liver cancer,it was confirmed by postoperative pathological analysis that there were 66 cases with MVI and 36 cases without MVI.The univariate analysis showed that incidence of multiple tumors,no or incomplete envelopes,rough tumor edge and rapid regression during portal phase in MVI group was higher than that in Non-MVI group,levels of serum AFP and CEA were higher than those in Non-MVI group(P<0.05).The multivariate Logisitic regression analysis found that multiple tumors and no or incomplete envelopes were independent risk factors of MVI after intervention surgery of liver cancer.After 1 year of follow-up,there were 21 cases with early recurrence.The univariate analysis showed that incidence of multiple tumors,no or incomplete envelopes,rapid regression during portal phase,internal necrosis of tumors and MVI in recurrence group was higher than that in non-recurrence group,levels of serum AFP and CEA were higher than those in non-recurrence group(P<0.05).The multivariate logisitic regression analysis found that MVI and and no or incomplete envelopes were independent risk factors of early recurrence.Conclusion The incidence of MVI is higher in liver cancer patients with multiple tumors and no or incomplete envelopes in CEUS examination.The possibility of early recurrence is higher in liver cancer patients with no or incomplete envelopes and MVI.The predictive value of serum AFP and CEA for MVI and early recurrence after intervention surgery of liver cancer needs to be further explored.