初治肝细胞癌的MSCT影像学特征对首次DEB-TACE术后疗效的评估价值

The value of MSCT imaging features of primary hepatocellular carcinoma in evaluating the curative effect after the frst DEB-TACE operation

目的探讨初治肝细胞癌的MSCT影像学特征对首次DEB-TACE术后疗效的评估价值。方法选择2017年1月~2021年9月在我院行DEB-TACE术的初治肝细胞癌患者111例。分别收集患者术前1周内、术后1月的上腹部CT增强数据及临床资料。按m RECIST标准评价首次DEB-TACE术后的疗效,将入组患者按疗效分成OR(CR+PR)组与非OR(SD+PD)组,统计分析CT影像学特征在两组之间的差异情况。结果单因素分析显示,肿瘤数量(P<0.001)、肿瘤最大径(P<0.001)和短长径比(P<0.001)、最大径同层比(P<0.001)是DEB-TACE治疗后OR差的危险因素。多因素Logistic回归分析显示,肿瘤数量(P=0.002)、肿瘤最大径(P=0.004)、短长径比(P=0.005)与最大径同层比(P<0.001)是DEB-TACE治疗后OR差的独立危险因素。结论MSCT影像学特征在预测初治肝细胞癌首次DEB-TACE术后疗效具有一定的临床价值。

Objective To discuss the value of MSCT imaging features of newly treated hepatocellular carcinoma(HCC)in evaluating the efficacy of the first DEB-TACE.Methods A total of 111 patients with newly diagnosed HCC who underwent DEB-TACE in our hospital from Jan 2017 to Sep 2021 were collected.The CT enhancement data of the upper abdomen within 1 week before operation and 1 month after operation were collected respectively.The curative effect after the first DEB-TACE was evaluated according to the mRECIST standard,and the enrolled patients were divided into OR(CR+PR)group and non-OR(SD+PD)group according to the curative effect,and the differences in CT imaging characteristics between the two groups were statistically analyzed.Results Univariate analysis showed that tumor number(P<0.001),tumor maximum diameter(P<0.001)and the ratio of short diameter to long diameter(P<0.001),maximum diameter-to-layer ratio(P<0.001)were risk factors for poor OR after DEBTACE treatment.In multivariate analysis,tumor number(P=0.002),maximum tumor diameter(P=0.004)and the ratio of short diameter to long diameter(P=0.005),maximum diameter-to-layer ratio(P<0.001)were also independent risk factors for poor OR after DEB-TACE treatment.Conclusion The imaging characteristics of MSCT have clinical value in predicting the efficacy of the first DEB-TACE for newly treated HCC.