MSCT联合血清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

Application value of MSCT combined with serum CCNA2 and AFP in the differential diagnosis of cirrhosis nodule and hepatocellular carcinoma

目的:探讨多层螺旋计算机断层扫描(MSCT)联合血清细胞周期素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月至2022年1月本院就诊的104例肝硬化结节和肝细胞肝癌患者。入院后,患者均给予腹部MSCT扫描及血清CCNA2和AFP水平检测。分析MSCT影像学特征及与MSCT鉴别诊断的一致性、血清CCNA2和AFP水平;绘制ROC曲线分析MSCT结合血清肿瘤标志物对肝硬化结节与肝细胞肝癌的鉴别价值。结果:104例患者经病理检查确诊肝硬化结节组70例、肝细胞肝癌组34例。MSCT的敏感度、特异度为76.47%、75.71%(Kappa=0.493);肝细胞肝癌组患者血清CCNA2和AFP水平显著高于肝硬化结节组(P<0.05);ROC结果显示,MSCT、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联合血清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:A total of 104 patients pathologically confirmed in the hospital were enrolled between January 2019 and January 2022,All underwent abdominal MSCT plain scan and enhancement scan to detect levels of serum CCNA2 and AFP.The imaging characteristics of MSCT in patients with cirrhosis nodules and hepatocellular carcinoma were analyzed.Taking pathological results as the golden standard,the consistency of MSCT in the differential diagnosis of hepatocellular carcinoma and cirrhosis nodule was compared.The levels of serum CCNA2and AFP were compared between the cirrhosis nodule group and the hepatocellular carcinoma group.The application value of MSCT combined with serum tumor markers in the differential diagnosis of cirrhosis nodules and hepatocellular carcinoma was detected by receiver operating characteristic(ROC)curves.Results:In the 104 patients,pathological examination showed that there were 70 cases in the cirrhosis nodule group and 34 cases in the hepatocellular carcinoma group.Taking pathological results as the golden standard,the sensitivity and specificity of MSCT in the differential diagnosis of hepatocellular carcinoma were 76.47%and 75.71%(Kappa=0.493).The levels of serum CCNA2 and AFP in the hepatocellular carcinoma group were significantly higher than those in the 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.The 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.