超声造影参数联合血清AFP、DKK1在原发性肝癌与转移性肝癌鉴别中的临床价值

Clinical Value of Contrast-Enhanced Ultrasound Parameters Combined with Serum AFP and DKK1 in the Differential Diagnosis of Primary Liver Cancer and Metastatic Liver Cancer

目的:探讨超声造影参数联合血清甲胎蛋白(AFP)、分泌型蛋白Dikkopf-1(DKK1)鉴别原发性肝癌(PLC)与转移性肝癌(MLC)的价值。方法:选取2020年2月至2022年12月我院收治的92例PLC患者(PLC组)、95例MLC患者(MLC组),所有患者均接受超声造影检查和血清AFP、DKK1水平检测。受试者工作特征(ROC)分析超声造影参数联合血清AFP、DKK1鉴别PLC和MLC的价值。结果:PLC组始增时间、增强速率、50%倾斜率低于MLC组(P<0.05),峰值时间、增强强度,血清AFP、DKK1水平高于MLC组(P<0.05)。始增时间、增强速率、50%倾斜率、峰值时间、增强强度、AFP、DKK1鉴别PLC与MLC的曲线下面积为0.725、0.655、0.716、0.697、0.761、0.695、0.754,联合应用鉴别PLC与MLC的曲线下面积为0.882,高于单独鉴别。结论:联合超声造影参数和血清AFP、DKK1在PLC和MLC鉴别中具有较高效能,优于单独影像或血清指标鉴别。

Objective:To explore the value of ultrasound contrast ultrasound parameters combined with serum alpha-fetoprotein(AFP)and secreted protein Dikkopf-1(DKK 1)to identify primary liver cancer(PLC)from metastatic liver cancer(MLC).Methods:92 PLC patients(PLC group)and 95 MLC patients(MLC group)who were admitted to our hospital from February 2020 to December 2022 were selected,all patients underwent contrast-enhanced ultrasound examination and serum AFP and DKK1 levels were detected.The value of contrast-enhanced ultrasound parameters combined with serum AFP and DKK1 in identifying PLC and MLC was analyzed by receiver operating characteristic(ROC).Results:Initiation time,Enhancement rate and 50%tilt rate in PLC group were lower than those in MLC group(P<0.05),and the peak time,Strengthing strength,serum AFP and DKK1 levels were higher than those in MLC group(P<0.05).The area under the curve of initiation time,Enhancement rate,50%tilt rate,peak time,Strengthing strength,AFP and DKK1 in differential diagnosis of PLC and MLC was 0.725,0.655,0.716,0.697,0.761,0.695 and 0.754 respectively,and the area under the curve identifying PLC from MLC was 0.882,higher than the identification alone.Conclusion:The combination of Ultrasound contrast parameters and serum AFP and DKK1 has high efficiency in the identification of PLC and MLC,better than imaging alone or serum index identification.