炎症标志物检测联合术前多模态MRI特征预测肝细胞癌微血管侵犯

Inflammatory marker detection combined with preoperative multimodal MRI features to predict microvascular invasion of hepatocellular carcinoma

目的:探讨炎症标志物检测联合术前多模态MRI特征对肝细胞癌微血管侵犯(MVI)的预测价值。方法:回顾性搜集120例经病理确诊的肝细胞癌患者,根据术后是否发生MVI将患者分为MVI组和非MVI组,其中MVI组69例,非MVI组51例,对两组患者的一般资料(年龄、性别、BMI、肿瘤分化、ALBI分级、Child Pugh分级)、炎症标志物[中性粒细胞/淋巴细胞比率(NLR)、全身免疫炎症指数(SII)]以及MRI特征进行比较,应用Logistic回归分析术后发生MVI的影响因素,并以炎症标志物和MRI特征联合绘制ROC曲线,分析对MVI的预测价值。结果:MVI组的NLR、SII、ADC平均值(ADCmean)和肿瘤直径均明显高于非MVI组,差异均具有统计学意义(P均<0.05)。多因素Logistic回归分析结果显示,NLR(OR=28.65,95%CI:3.690~501.4,P=0.005)、SII(OR=1.060,95%CI:1.029~1.109,P=0.001)、ADCmean(OR=1.23×10^(5),95%CI:526.0~9.29×10^(8),P=0.001)和肿瘤直径(OR=1.065,95%CI:1.022~1.127,P=0.008)均是影响术后发生MVI的危险因素。ROC曲线分析结果显示,NLR、SII、ADCmean和肿瘤直径联合预测发生MVI的效能最高(AUC=0.889)。结论:炎症标志物检测联合术前多模态MRI对肝细胞癌术后发生MVI有较高的预测价值。

Objective:This article was aimed to explore the predictive value of inflammatory marker detection combined with preoperative multimodal MRI for microvascular invasion(MVI)in hepatocellular carcinoma.Methods:A retrospective analysis of 120 patients diagnosed with hepatocellular carcinoma was performed and divided into MVI group and non-MVI group according to whether MVI occurred after surgery,including 69 cases in MVI group and 51 cases in non-MVI group,and analyzed and compared the general data(age,sex,BMI,tumor differentiation,ALBI grade,Child Pugh grade),inflammatory markers(NLR,SII)and MRI characteristics of the two groups were analyzed and compared.Logistic was used to analyze the influencing factors of MVI after surgery.ROC curves were jointly plotted by inflammatory markers and MRI features to analyze the predictive value of MVI.Results:The results showed that the NLR,SII,ADCmean and tumor diameter in the MVI group were significantly higher than those in the non-MVI group,and the differences were statistically significant(all P<0.05).Multivariate logistic regression analysis showed NLR(OR=28.65,95%CI:3.690~501.4,P=0.005),SII(OR=1.060,95%CI:1.029~1.109,P=0.001),ADCmean(OR=1.23×10^(5),95%CI:526.0~9.29×10^(8),P=0.001)and tumor diameter(OR=1.065,95%CI:1.022~1.127,P=0.008)were all risk factors affecting the occurrence of MVI after surgery.The results of ROC curve showed that the combination of NLR,SII,ADCmean and tumor diameter had a higher predictive value(AUC=0.889).Conclusion:Inflammatory marker detection combined with preoperative multimodal MRI has a high predictive value for MVI after hepatocellular carcinoma.