MSCT结合血清CCNA2、AFP检测在肝硬化结节与肝细胞肝癌鉴别诊断中的应用价值研究

Application Value of MSCT Combined with Serum CCNA2 and AFP in the Differential Diagnosis of Cirrhosis Nodule and Hepatocelular Carcinoma

目的探讨多层螺旋计算机断层扫描(MSCT)结合血清细胞周期素A2(CCNA2)、甲胎蛋白(AFP)在肝硬化结节与肝细胞肝癌鉴别诊断中的应用价值。方法选取2019年1月~2022年1月本院收治的经病理证实的104例肝硬化结节与肝细胞肝癌患者,其中肝硬化结节69例,肝细胞肝癌35例,均接受腹部MSCT平扫及增强扫描,检测血清CCNA2和AFP水平。分析肝硬化结节和肝细胞肝癌患者的MSCT影像学特征和肝硬化结节组和肝细胞肝癌组血清CCNA2和AFP水平;绘制受试者操作特征曲线(ROC)分析MSCT结合血清肿瘤标志物鉴别肝硬化结节与肝细胞肝癌的应用价值。结果104例患者经病理检查确肝硬化结节组69例、肝细胞肝癌组35例。以病理诊断为“金标准”,MSCT鉴别诊断肝细胞肝癌的敏感度、特异度为77.14%、75.36%(Kappa=0.493);肝细胞肝癌组血清CCNA2和AFP水平显著高于肝硬化结节组(P<0.05);ROC结果显示,MSCT和血清CCNA2和AFP预测肝细胞肝癌的曲线下面积(AUC)分别为0.886、0.836和0.775,MSCT结合血清CCNA2和AFP预测肝细胞肝癌的AUC为0.902,敏感度为82.86%(P<0.05)。结论MSCT结合血清CCNA2、AFP检测在肝硬化结节和肝细胞肝癌的临床鉴别中具有较好的应用价值。

Objective To explore the application value of multi-slice spiral computed tomography(MSCT)combined with serum cyclin A2(CCNA2)and alpha-fetoprotein(AFP)in the differential diagnosis of cirrhosis nodule and hepatocellular carcinoma.Methods 104 patients with liver cirrhosis nodules and hepatocellular carcinoma confirmed by pathology admitted to our hospital from January 2019 to January 2022 were selected,including 69 cases of liver cirrhosis nodules and 35 cases of hepatocellular carcinoma.All patients underwent abdominal MSCT plain and enhanced scans to detect serum CCNA2 and AFP levels.Analyze the MSCT imaging features of patients with liver cirrhosis nodules and hepatocellular carcinoma,as well as the serum levels of CCNA2 and AFP in the liver cirrhosis nodule group and hepatocellular carcinoma group;Draw receiver operating characteristic(ROC)curves to analyze the application value of MSCT combined with serum tumor markers in distinguishing liver cirrhosis nodules from hepatocellular carcinoma.Results In the 104 patients,pathological examination showed that there were 69 cases in cirrhosis nodule group and 35 cases in hepatocellular carcinoma group.Taking pathological results as the golden standard,the sensitivity and specificity of MSCT in the differential diagnosis of hepatocellular carcinoma were 77.14%and 75.36%(Kappa=0.493).The levels of serum CCNA2 and AFP in hepatocellular carcinoma group were significantly higher than those in cirrhosis nodule group(P<0.05).The results of ROC curves analysis showed that area under the curve(AUC)values of MSCT,serum CCNA2 and AFP for predicting hepatocellular carcinoma were 0.886,0.836 and 0.775,respectively.AUC and sensitivity of MSCT combined with serum CCNA2 and AFP for predicting hepatocellular carcinoma were 0.902 and 82.86%(P<0.05).Conclusion MSCT combined with serum CCNA2 and AFP has high clinical application value in the differential diagnosis of cirrhosis nodules and hepatocellular carcinoma.