多层螺旋CT扫描联合血清CHI3L1、GP73检测在原发性肝癌的临床诊断中的应用价值

Analysis of Clinical Diagnosis of Primary Hepatic Carcinoma by Multi-slice Spiral CT Scan Combined with Serum CHI3L1 and GP73 Detection

目的分析多层螺旋CT(MSCT)扫描联合血清壳多糖酶3样蛋白1(CHI3L1)、高尔基体蛋白73(GP73)检测在原发性肝癌(PHC)临床诊断中的应用价值。方法选择疑似PHC患者112例,依据病理检查结果分成PHC组57例与良性肝病组55例,另选同期健康体检者(对照组)60例。所有研究对象均进行MSCT扫描,观察血流量(BF)、肝动脉灌注量(AP)、平均通过时间(MTT)、对比剂到达时间(IRF To);检测血清CHI3L1、GP73水平,对MSCT扫描、CHI3L1、GP73水平的诊断结果进行比较,评估其联合用于PHC的诊断效能。结果PHC组PHC组织及其癌旁组织的BF、AP、MTT较对照组高(P<0.05),IRF To较对照组低(P<0.05);PHC组PHC组织的BF、AP、MTT较PHC组癌旁组织与良性肝病组高(P<0.05),IRF To较PHC组癌旁组织与良性肝病组低(P<0.05)。PHC组的血清CHI3L1、GP73水平高于良性肝病组与对照组(P<0.05),良性肝病组的血清CHI3L1、GP73水平高于对照组(P<0.05)。MSCT扫描联合血清CHI3L1、GP73检测对PHC的阳性检出率最高。MSCT扫描联合血清CHI3L1、GP73检测对PHC具有良好的诊断效能(Kappa>0.8),灵敏度、特异度、准确率均优于单项检测。结论MSCT扫描联合血清CHI3L1、GP73检测可提高PHC的诊断价值。

Objective To analyze the application value of multi-slice spiral CT(MSCT)scan combined with detection of serum chitinase 3-like protein 1(CHI3L1)and Golgi protein 73(GP73)in the clinical diagnosis of primary hepatic carcinoma(PHC).Methods A total of 112 patients with suspected PHC accepted by our hospital were collected and grouped into PHC group with 57 cases and benign liver disease group with 55 cases according to the results of pathological examination.All subjects underwent MSCT scan was performed to observe blood flow(BF),hepatic artery perfusion(AP),mean transit time(MTT),and contrast agent arrival time(IRF To);the serum CHI3L1 and GP73 levels were detected,and the diagnostic results of MSCT scan,CHI3L1 and GP73 levels were compared,and their combined diagnostic efficacy for PHC was evaluated.Results The BF,AP and MTT of PHC tissue and its adjacent tissue in the PHC group were higher than those in the control group(P<0.05),and the IRF To was lower than that in the control group(P<0.05);the BF,AP,and MTT of PHC tissue in the PHC group were higher than those in the adjacent tissue of the PHC group and the benign liver disease group(P<0.05),and IRF To was lower than that in PHC group and benign liver disease group(P<0.05).The levels of serum CHI3L1 and GP73 in the PHC group were higher than those in the benign liver disease group and the control group(P<0.05),and the levels of serum CHI3L1 and GP73 in the benign liver disease group were higher than those in the control group(P<0.05).MSCT scan combined with serum CHI3L1 and GP73 detection had the highest positive detection rate for PHC.MSCT scan combined with serum CHI3L1 and GP73 detection had good diagnostic performance for PHC(Kappa>0.8),and the sensitivity,specificity and accuracy were better than single detection.Conclusion MSCT scan combined with serum CHI3L1 and GP73 detection can improve the diagnostic value of PHC.