超声造影联合血清AFP预测微波消融术治疗原发性肝癌的疗效

Efficacy of contrast-enhanced ultrasound combined with serum AFP in predicting primary liver cancer by microwave ablation

目的探究超声造影联合血清甲胎蛋白(alpha-fetoprotein,AFP)对微波消融术治疗原发性肝癌的预测价值。方法收集2020年7月至2022年8月于树兰(杭州)医院就诊的148例原发性肝癌患者,采用随机数字表法分为微波消融组和对照组,每组74例。微波消融组患者采用化疗联合微波消融术治疗,对照组患者仅采用化疗,比较两组患者的预后情况。根据微波消融组患者预后情况分为预后良好组与预后不良组,分析预后良好组与预后不良组患者超声造影微波消融灶截面积、血清AFP指标差异。采用受试者操作特征曲线下面积(area under the curve,AUC)分析诊断价值,采用Pearson法分析相关性。结果预后良好组、预后不良组、微波消融组、对照组累计生存率分别为100.00%、10.71%、49.11%、14.51%。术后6个月,预后良好组与预后不良组超声造影微波消融灶截面积均增加,且预后良好组大于预后不良组(P<0.05);预后良好组血清AFP水平下降,预后不良组水平上升(P<0.05)。超声造影微波消融灶截面积、血清AFP及联合检测预测原发性肝癌预后的AUC分别为0.760、0.740、0.833。超声造影微波消融灶截面积与死亡患者生存时间呈正相关,血清AFP与生存时间呈负相关(P<0.05)。结论超声造影联合血清AFP对原发性肝癌疗效有较好的预测价值。

Objective To explore the predictive value of contrast-enhanced ultrasound combined with serum alpha-fetoprotein(AFP)in the treatment of primary liver cancer by microwave ablation.Methods A total of 148 patients with primary liver cancer treated in Shulan(Hangzhou)Hospital from July 2020 to August 2022 were collected and divided into microwave ablation group and control group by random number table method,with 74 cases in each group.The microwave ablation group was treated with chemotherapy combined with microwave ablation,while the control group was treated with chemotherapy only,and the prognosis of two groups were compared.According to the prognosis,the microwave ablation group was divided into good prognosis group and poor prognosis group,.The differences in the cross-sectional area of microwave ablation foci and serum AFP index between the good prognosis group and the poor prognosis group were analyzed.The diagnostic value was analyzed by area under the curve(AUC),and the correlation was analyzed by Pearson method.Results The cumulative survival rates of the good prognosis group,the poor prognosis group,the microwave ablation group and the control group were 100.00%,10.71%,49.11%and 14.51%,respectively.Six months after operation,the cross-sectional area of microwave ablation foci in both the good prognosis group and the poor prognosis group increased,and the good prognosis group was larger than the poor prognosis group(P<0.05);The serum AFP level in the good prognosis group was decreased,and the level in the poor prognosis group was increased(P<0.05);The cross-sectional area of microwave ablation foci,serum AFP and AUC values of combined detection were 0.760,0.740 and 0.833,respectively.The cross-sectional area of microwave ablation and serum AFP were positively and negatively correlated with survival(P<0.05).Conclusion Contrast-enhanced ultrasound combined with serum AFP has a good predictive value in the efficacy of primary liver cancer.