DCE-MRI减影联合血清miR-133a-3p及CCR3预测TACE治疗肝细胞癌早期效果

DCE-MRI subtraction combined with serum miR-133a-3p and CCR3 in predicting early effect of TACE for treating hepatocellular carcinoma

目的观察动态增强MRI(DCE-MRI)减影联合血清微小RNA-133a-3p(miR-133a-3p)及CC趋化因子受体3(CCR3)预测TACE治疗肝细胞癌(HCC)早期效果的效能。方法对107例HCC行TACE,1个月后根据实体肿瘤疗效评价标准将其分为疗效良好组(部分缓解+完全缓解)和疗效不良组(稳定+进展)。对比2组术前DCE-MRI减影参数动脉期、门静脉期对比噪声比(CNR)及血清miR-133a-3p、CCR3水平;采用受试者工作特征(ROC)曲线分析CNR联合血清miR-133a-3p及CCR3预测TACE治疗早期效果的效能。结果62例疗效良好,45例疗效不良。TACE前,疗效不良组动脉期CNR高于、门静脉期CNR低于疗效良好组,血清miR-133a-3p水平低于、CCR3水平高于疗效良好组(P均<0.001)。ROC曲线结果显示,动脉期CNR、门静脉期CNR、血清miR-133a-3p和CCR3以及四者联合预测TACE治疗早期效果的曲线下面积(AUC)分别为0.785、0.761、0.692、0.707及0.919,特异度分别为88.7%、74.2%、51.6%、77.4%及95.2%,敏感度分别为64.4%、71.1%、82.2%、57.8%及75.6%,四者联合的AUC高于各单独指标(P均<0.05)。结论DCE-MRI减影参数CNR及血清miR-133a-3p、CCR3均可用于预测TACE治疗HCC早期效果,且联合预测效能更高。

Objective To explore the value of dynamic contrast-enhanced MRI(DCE-MRI)subtraction combined with serum microRNA-133a-3p(miR-133a-3p)and CC chemokine receptor 3(CCR3)in predicting early efficacy of TACE for hepatocellular carcinoma(HCC).Methods TACE was performed in 107 patients with HCC.One month after TACE,the patients were divided into good efficacy group(partial remission+complete remission)or poor efficacy group(stability+progression)according to the evaluation of solid tumor efficacy criteria.The contrast noise ratio(CNR)values in arterial and portal vein phases,as well as serum miR-133a-3p and CCR3 levels before TACE were compared between groups.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of CNR combined with serum miR-133a-3p and CCR3 in predicting the early efficacy of TACE for treating HCC.Results Good efficacy was observed in 62 cases,while poor efficacy was found in 45 cases.In poor efficacy group,the arterial phase CNR was higher,portal vein phase CNR was lower than those in good efficacy group,and serum miR-133a-3p level was lower and CCR3 level was higher than those in good efficacy group(all P<0.001).ROC curve showed that the area under the curve(AUC)of arterial phase CNR,portal vein phase CNR,serum miR-133a-3p,CCR3 and the combination of the above four for predicting early effect of TACE for HCC was 0.785,0.761,0.692,0.707 and 0.919,respectively,with specificity of 88.7%,74.2%,51.6%,77.4%and 95.2%,and sensitivity of 64.4%,71.1%,82.2%,57.8%and 75.6%,respectively.The AUC of combining prediction was higher than that of prediction according to each single index(all P<0.05).Conclusion DCE-MRI subtraction technical parameter CNR,serum miR-133a-3p and CCR3 could be used to predict early effect of TACE for treating HCC,and the combination of them had the highest prediction efficiency.