CT技术联合CTCs、AFP对肝细胞癌微血管侵犯的预测价值

The predictive value of CT combined with CTCs and AFP in diagnosing microvascular invasion in hepatocellular carcinoma

目的研究CT技术联合外周血循环肿瘤细胞(CTCs)、血清甲胎蛋白(AFP)对肝细胞癌(HCC)微血管侵犯(MVI)的预测价值。方法选取河南新乡医学院第一附属医院92例行根治性切除术的HCC患者,经过术后检测是否存在MVI分为MVI组(34例)和非MVI组(58例)。比较两组患者的临床资料:术前对患者进行CT扫描,对两组患者影像学资料进行判断和分析;术前对两组患者进行CTCs、AFP检测,对HCC患者发生MVI的危险因素进行多因素分析。结果MVI组的肿瘤直径≥5 cm、多结节型、CTCs阳性、血清AFP>400μg/L占比人数显著高于非MVI组,肿瘤包膜完整的占比人数显著低于非MVI组(P<0.05);肿瘤直径、结节类型、肿瘤包膜、CTCs、血清AFP是HCC患者发生MVI的危险因素(P<0.05)。结论肿瘤直径、结节类型、肿瘤包膜、CTCs、血清AFP是HCC患者发生MVI的独立危险因素,因此临床上可以通过术前使用CT技术联合CTCs、AFP对肝癌患者术后是否存在MVI进行预测评估。

Objective To investigate the value of computer tomography(CT)combined with circulating tumor cells(CTCs),and serum alpha fetoprotein(AFP)in predicting microvascular invasion(MVI)in hepatocellular carcinoma(HCC).Methods Ninety-two HCC patients who underwent radical resection in our hospital were selected,they were divided into MVI group(34 cases)and non MVI group(58 cases)according to postoperative pathological results.The clinical data of the 2 groups were compared.All patients underwent CT before operation,and the imaging data of the 2 groups were analyzed.The levels of CTCs and AFP were detected before operation.Risk factors of MVI in HCC patients were analyzed by multivariate analysis.Results The proportions of tumor diameter≥5 cm,multinodular type,CTCs positive,serum AFP>400μg/L in MVI group were significantly higher than those in non MVI group,and the proportion of tumor capsule integrity was significantly lower than that in non MVI group(P<0.05);tumor diameter,nodule type,tumor capsule,CTCs and serum AFP levels were independent risk factors for MVI in HCC patients(P<0.05).Conclusion Tumor diameter,nodule type,tumor capsule,CTCs and serum AFP are independent risk factors for MVI in HCC patients.Therefore,CT combined with CTCs and AFP can be used to predict the presence of MVI in HCC patients before operation.