MSCT影像表现对原发性肝细胞肝癌术后残留病灶检出率和复发的预测及与疗效的相关性

Prediction of MSCT imaging manifestations on the detection rate and recurrence of residual lesions after primary hepatocellular carcinoma and its correlation with curative effect

目的:分析MSCT影像表现对原发性肝细胞肝癌(PHCC)术后残留病灶检出率和复发的预测及与疗效的相关性。方法:选择我院2019年8月-2022年12月间收治的102例行经导管动脉化疗栓塞术(TACE)的PHCC患者作为研究对象,治疗前及术后半年时对患者行MSCT增强扫描,术后半年时行血管造影检查,术后半年时对患者临床疗效进行评估,以血管造影为金标准,采用Spearman相关性检验分析MSCT影像表现与疗效相关性,绘制ROC曲线分析MSCT对病灶复发的预测价值。结果:与金标准血管造影相比,MSCT扫描检测的术后残留病灶检出7例,血管造影检出9例;治疗后患者BV、BF、PS及HAF水平均明显低于治疗前,且差异存在统计学意义(P<0.05);治疗后患者HAP、HPI及TLP水平均明显低于治疗前,PVP明显高于治疗前,且差异存在统计学意义(P<0.05);患者治疗后显效7例,有效64例,稳定29例,无效2例,对治疗疗效不同患者进行分析显示,有效组患者BV、BF、PS及HAF水平均明显低于无效组,且差异存在统计学意义(P<0.05);治疗后有效组患者HAPHPI及TLP水平均明显低于无效组,PVP明显高于无效组,且差异存在统计学意义(P<0.05);患者MSCT影像学检查BF、BV、PS、HAF、HAP、HPI、TLP与患者治疗临床疗效呈显著负相关关系,PVP与患者治疗临床疗效呈显著正相关关系(P<0.05);利用MSCT扫描检查预测PHCC的敏感度为92.77%,特异度为84.21%;利用MSCT扫描预测PHCC术后复发的AUC为0.853,具有较高的应用价值(P<0.05)。结论:MSCT扫描检查可有效检出PHCC病灶,且MSCT扫描检查指标与患者临床疗效高度相关,且MSCT扫描检查可有效预测患者术后复发。

Objective:To analyze the correlation between MSCT imaging performance and the prediction of residual lesion detection rate and recurrence of primary hepatocellular carcinoma(PHCC)after surgery and the curative effect.Methods:A total of 102 patients with PHCC who underwent transcatheter arterial chemoembolization(TACE)in our hospital from August 2019 to December 2022 were selected as research objects.Enhanced MSCT scans were performed on the patients before treatment and half a year after surgery.Angiography examination was performed half a year after the operation.The clinical curative effect of patients was evaluated half a year after the operation.The angiography was regarded as gold standard.Spearman correlation test was used to analyze the correlation between MSCT image performance and curative effect,and the ROC curve was drawn to analyze the effect of MSCT on lesion recurrence predictive value.Results:Compared with the gold standard angiography,MSCT scanning detected 7 cases of postoperative residual lesions,and angiography detected 9 cases.The levels of BV,BF,PS and HAF in patients after treatment were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).The levels of HAP,HPI and TLP after treatment were significantly lower than those before treatment,and PVP was significantly higher than that of before treatment,and the difference was statistically significant(P<0.05).Among these patients,7 cases were significantly effective,64 cases were effective,29 cases were stable,and 2 cases were ineffective.The analysis of patients with different curative effects showed that the levels of BV,BF,PS and HAF in the effective group were significantly lower than those in the ineffective group,and the difference was statistically significant(P<0.05).after treatment,the levels of HAP,HPI and TLP in the effective group were significantly lower than those in the ineffective group,and the PVP was significantly higher than that in the ineffective group,and the difference was statistically significant(P<0.05).BF,BV in the MSCT imaging examination of patients,PS,HAF,HAP,HPI,TLP were significantly negatively correlated with clinical efficacy of patients,and PVP was significantly positively correlated with clinical efficacy of patients(P<0.05).The sensitivity was 92.77%,and the specificity was 84.21%.The AUC of predicting postoperative recurrence of PHCC by MSCT scanning was 0.853,which has high application value(P<0.05).Conclusion:MSCT scanning can effectively detect PHCC lesions,and the indicators of MSCT scanning are highly correlated with the clinical efficacy of patients,and MSCT scanning can effectively predict the recurrence of patients after surgery.