超声造影联合实验室指标诊断早期肝硬化结节状小肝癌的价值

Value of contrast-enhanced ultrasound combined with laboratory indicators in the diagnosis of small nodular liver cancer in early cirrhosis

目的探讨超声造影联合血清甲胎蛋白(AFP)、磷脂酰肌醇蛋白聚糖3(GPC3)对早期肝硬化结节状小肝癌的诊断价值。方法回顾性分析78例早期发现肝硬化合并小结节样病灶患者的临床资料,根据病理结果分为小肝癌组(46例)和良性病变组(32例)。两组术前均行超声造影和血清AFP、GPC3水平检测,结果进行比较。分析超声造影、血清AFP、GPC3单独及联合应用对小肝癌的诊断效能。结果小肝癌组超声造影特征、血清AFP、GPC3与良性病变组比较差异均有统计学意义(均P<0.05)。超声造影联合血清AFP、GPC3诊断小肝癌的准确率、敏感性、特异性、阳性预测值、阴性预测值分别为92.31%、95.65%、87.50%、91.67%、93.33%,与其余指标单独或两两联合应用比较差异均有统计学意义(均P<0.05)。结论超声造影联合血清AFP、GPC3有助于早期肝硬化结节状小肝癌的鉴别诊断,具有较好的临床应用价值。

Objective To investigate the diagnostic value of contrast-enhanced ultrasound combined with serum alpha-fetoprotein(AFP)and glypican 3(GPC3)for early liver cirrhosis and nodular in patients with small liver cancer.Methods The clinical data of 78 patients with early detection of liver cirrhosis complicated with small nodular lesions were retrospectively analyzed.According to the pathological results,they were divided into small liver cancer group(n=46)and benign lesion group(n=32).All patients underwent contrast-enhanced ultrasound,serum AFP and GPC3 measurement before operation.The differences in parameters between the two groups were compared.The efficacy of contrast-enhanced ultrasound,serum AFP and GPC3 or their combination in the diagnosis of small liver cancer were analyzed.Results The contrast-enhanced ultrasound characteristics,serum AFP and GPC3 of the small liver cancer group were significantly different from those of the benign lesion group(all P<0.05),and the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of contrastenhanced ultrasound combined with serum AFP and GPC3 in the diagnosis of small liver cancer were 92.31%,95.65%,87.50%,91.67%,93.33%,respectively.There were statistically significant differences between other indicators alone or in two combination(all P<0.05).Conclusion Contrast-enhanced ultrasound combined with serum AFP and GPC3 can improve the differential diagnostic value of small nodular liver cancer in early cirrhosis,and has good clinical application value.