肝特异性对比剂MR扫描联合异常糖链糖蛋白、甲胎蛋白、甲胎蛋白异质体L3检测在乙肝相关性肝细胞癌诊断中的应用价值

Application value of liver-specific contrast agent MR scan combined with tumor abnormal protein,alpha-fetoprotein and alpha-fetoprotein-L3 in the diagnosis of hepatitis B-related hepatocellular carcinoma

目的探讨肝特异性对比剂MR扫描联合异常糖链糖蛋白(TAP)、甲胎蛋白(AFP)、甲胎蛋白异质体L3(AFP-L3)检测在乙肝相关性肝细胞癌(HCC)诊断中的应用价值。方法将62例乙肝相关性HCC患者纳入HCC组,53例良性肝病患者纳入良性肝病组。检测两组的TAP、AFP和AFP-L3,计算AFP-L3/AFP(AFP-L3%);对患者行上腹部MR平扫及肝特异性对比剂增强扫描,分析两组的MR影像表现。绘制受试者工作特征(ROC)曲线并分别探讨MR扫描、TAP、AFP、AFP-L3%单独及联合检测对乙肝相关性HCC的诊断价值。结果HCC组的TAP、AFP及AFP-L3%显著高于良性肝病组,差异具有统计学意义(P<0.05)。ROC曲线显示,MR扫描、TAP、AFP、AFP-L3%单独及联合检测乙肝相关性HCC的曲线下面积(AUC)分别为0.904、0.742、0.772、0.826、0.931,联合检测的诊断效能最高。结论肝特异性对比剂MR扫描联合TAP、AFP、AFP-L3%检测对于乙肝相关性HCC的诊断具有重要的临床价值。

Objective To investigate the application value of liver-specific contrast agent MR scan combined with tumor abnormal protein(TAP),alpha-fetoprotein(AFP)and alpha-fetoprotein-L3(AFP-L3)in the diagnosis of hepatitis B-related hepatocellular carcinoma(HCC).Methods Sixty-two patients with hepatitis B-related HCC were included in HCC group and 53 patients with benign liver disease were included in benign liver disease group.The TAP,AFP and AFP-L3 of the two groups were detected,and the AFP-L3/AFP(AFP-L3%)was calculated.The patients underwent upper abdominal MR plain scan and liver-specific contrast-enhanced scan,and the MR imaging findings of the two groups were analyzed.The receiver operating characteristic(ROC)curve was drawn,and the diagnostic value of MR scan,TAP,AFP,AFP-L3%alone and combined detection for hepatitis B-related HCC were discussed.Results The TAP,AFP and AFP-L3%in the HCC group were significantly higher than those in the benign liver disease group,and the differences were statistically significant(P<0.05).ROC curve showed that the area under the curve(AUC)of MR scan,TAP,AFP,AFP-L3%alone and combined detection of hepatitis B-related HCC were 0.904,0.742,0.772,0.826 and 0.931,respectively.The diagnostic efficiency of combined detection was the highest.Conclusion Liver-specific contrast agent MR scan combined with TAP,AFP,AFP-L3%detection has important clinical value for the diagnosis of hepatitis B-related HCC.