血清DKK1、FGF19联合CT在原发性肝癌患者介入治疗疗效评估中的应用价值

The Application Value of Serum DKK1,FGF19 Combined with CT in Evaluating the Efficacy of Interventional Therapy in Patients with Primary Hepatic Carcinoma

目的探讨血清Dickkopf-1(DKK1)、成纤维细胞生长因子19(FGF19)联合计算机断层扫描(CT)对原发性肝癌(PHC)患者经导管动脉栓塞化疗(TACE)的疗效评估价值。方法分别纳入2022年1月-2023年2月本院136例PHC患者,TACE治疗2个月后依据疗效分为灭活组(59例)与残留组(77例)。双抗体夹心法检测血清DKK1、FGF19水平,并对患者进行CT扫描。ROC曲线获取血清DKK1、FGF19诊断PHC患者TACE治疗后疗效的最佳截断值。以数字减影血管造影检查(DSA)为金标准,探讨血清DKK1、FGF19联合CT扫描对TACE治疗后疗效的诊断价值。采用Kappa检验分析血清DKK1、FGF19联合CT诊断PHC疗效与DSA结果一致性。结果残留组患者血清DKK1、FGF19水平分别为(2.41±0.33)ng/mL、(206.72±21.60)pg/mL,明显高于灭活组的(1.87±0.29)ng/mL、(169.57±18.45)pg/mL,差异有统计学意义(P<0.05)。ROC曲线显示,血清DKK1、FGF19水平诊断PHC患者TACE治疗后疗效的曲线下面积分别为0.925、0.916,敏感度为83.12%、84.42%,特异度为91.52%、94.92%。CT扫描评估PHC患者TACE治疗疗效与DSA结果一致性高,Kappa值=0.766(P<0.05)。血清DKK1、FGF19联合CT扫描诊断疗效的准确度为93.38%,敏感度、特异度为96.10%、89.83%,且联合检测的敏感度明显优于单独DKK1、FGF19、CT扫描(P<0.05)。结论血清DKK1、FGF19联合CT扫描对PHC患者TACE治疗后疗效有一定诊断价值。

Objective To explore the value of serum Dickkopf-1(DKK1),fibroblast growth factor 19(FGF19)combined with computed tomography(CT)in evaluating the efficacy of transcatheter arterial chemoembolization(TACE)in patients with primary hepatic carcinoma(PHC).Methods A total of 136 PHC patients in our hospital from January 2022 to February 2023 were included.After 2 months of TACE treatment,they were grouped into an inactivated group(59 cases)and a residual group(77 cases)based on their efficacy.The double antibody sandwich method was applied to detect serum DKK1 and FGF19 levels,and CT scans were performed on patients.ROC curve was applied to obtain the optimal cutoff values for the efficacy of TACE treatment in diagnosing PHC patients with serum DKK1 and FGF19.Using digital subtraction angiography(DSA)as the gold standard,the diagnostic value of serum DKK1,FGF19 combined with CT scan for the efficacy of TACE treatment was explored.Kappa test was applied to analyze the consistency between the efficacy of serum DKK1,FGF19 combined with CT in diagnosing PHC and DSA results.Results The serum levels of DKK1 and FGF19 in the residual group were(2.41±0.33)ng/mL and(206.72±21.60)pg/mL,respectively,which were obviously higher than those in the inactivated group(1.87±0.29)ng/mL and(169.57±18.45)pg/mL(P<0.05).The ROC curve showed that the area under the curve for diagnosing the efficacy of TACE treatment in PHC patients with serum DKK1 and FGF19 levels was 0.925 and 0.916,respectively,with sensitivity of 83.12%and 84.42%,specificity of 91.52%and 94.92%.CT scan evaluation of TACE treatment efficacy in PHC patients showed high consistency with DSA results,with Kappa value=0.766(P<0.05).The accuracy of serum DKK1,FGF19 combined with CT scan in diagnosing efficacy was 93.38%,and the sensitivity and specificity were 96.10%and 89.83%,respectively,the sensitivity of the combined detection was obviously better than that of single DKK1,FGF19,and CT scan(P<0.05).Conclusion The combination of serum DKK1 and FGF19 with CT scan has certain diagnostic value for the efficacy of TACE treatment in PHC patients.