多层螺旋CT联合miR-527、miR-25检测对早期原发性肝癌诊断的临床价值

The Clinical Value of Multi-slice Spiral CT Combined with miR-527 and miR-25 Detection in the Diagnosis of Early Primary Liver Cancer

目的分析多层螺旋CT联合血清miR-527、miR-25检测对早期原发性肝癌诊断的临床价值。方法选取本院2022年1月至2023年5月收治的原发性肝癌患者78例,同期良性肝病患者50例,对患者进行多层螺旋CT扫描,qRT-PCR法检测血清miR-527、miR-25水平。ROC曲线分析血清miR-527、miR-25水平对原发性肝癌的诊断价值;四表格法分析多层螺旋CT联合血清miR-527、miR-25对原发性肝癌的诊断价值。结果原发性肝癌患者血清miR-527、miR-25水平显著高于良性肝病患者(P<0.05);ROC曲线结果表明,血清miR-527水平诊断原发性肝癌的AUC为0.753,敏感性为74.36%,特异性为70.00%;血清miR-25水平诊断发生原发性肝癌的AUC为0.722,敏感性为61.54%,特异性为72.00%。多层螺旋CT扫描诊断结果显示,原发性肝癌患者76例,其中弥漫型肝癌12例,结节型肝癌38例,巨块型肝癌26例;良性肝病患者52例。多层螺旋CT扫描诊断原发性肝癌的敏感性为78.21%(61/78),特异性为70.00%(35/50),准确度为75.00%(96/128);多层螺旋CT扫描对原发性肝癌的诊断结果与术后病理诊断结果具有一致性(Kappa值=0.479,P<0.05)。多层螺旋CT联合血清miR-527、miR-25水平诊断原发性肝癌的敏感性为96.15%(75/78)、特异性为68.00%(34/50),准确度为85.16%(109/128);三者联合对原发性肝癌的诊断结果与术后病理诊断结果具有较好一致性(Kappa值=0.673,P<0.05),且联合诊断的敏感性和准确度显著高于多层螺旋CT、miR-527、miR-25单独诊断(P<0.05)。结论多层螺旋CT联合血清miR-527、miR-25检测对早期原发性肝癌诊断准确度较高,具有重要的临床价值。

Objective To analyze the clinical value of multi-slice spiral CT combined with serum miR-527 and miR-25 detection in the diagnosis of early primary liver cancer.Methods From January 2022 to May 2023,78 patients with primary liver cancer and 50 patients with benign liver diseases admitted to our hospital were collected.Multi slice spiral CT scans were performed on the patients,and serum miR-527 and miR-25 levels were measured using qRT-PCR.Receiver operating characteristic was applied to analyze the diagnostic value of serum miR-527 and miR-25 levels for primary liver cancer;the four grid table method was applied to analyze the diagnostic value of multi-slice spiral CT combined with serum miR-527 and miR-25 for primary liver cancer.Results The serum levels of miR-527 and miR-25 in patients with primary liver cancer were obviously higher than those in patients with benign liver disease(P<0.05);the results of ROC curve showed that the AUC of serum miR-527 level in the diagnosis of primary liver cancer was 0.753,the sensitivity was 74.36%,and the specificity was 70.00%;the AUC serum miR-25 level in the diagnosis of primary liver cancer was 0.722,with a sensitivity of 61.54%and a specificity of 72.00%.The diagnostic results of multi-slice spiral CT scanning showed that there were 76 patients with primary liver cancer,including 12 cases of diffuse liver cancer,38 cases of nodular liver cancer,and 26 cases of massive liver cancer;52 patients with benign liver disease.The sensitivity of multi-slice spiral CT scanning in the diagnosis of primary liver cancer was 78.21%(61/78),the specificity was 70.00%(35/50),and the accuracy was 75.00%(96/128);the diagnostic results of multi-slice spiral CT scanning for primary liver cancer were consistent with postoperative pathological diagnosis(Kappa value=0.479,P<0.05).The sensitivity,specificity,and accuracy of multi-slice spiral CT combined with serum miR-527 and miR-25 levels in the diagnosis of primary liver cancer were 96.15%(75/78),68.00%(34/50),and 85.16%(109/128),respectively;the combined diagnosis of primary liver cancer showed good consistency with postoperative pathological diagnosis(Kappa value=0.673,P<0.05),and the sensitivity and accuracy of the combined diagnosis were obviously higher than those of multi-slice spiral CT,miR-527,and miR-25 alone(P<0.05).Conclusion Multi slice spiral CT combined with serum miR-527 and miR-25 detection has high diagnostic accuracy for early primary liver cancer and important clinical value.