학술논문
Gd-EOB-DTPA增强MRI预测CK19阳性肝细胞癌及其预后的临床价值 / Clinical Value of Disodium Gd-EOB-DTPA Enhanced MRI in Predicting CK19 Positive Hepatocellular Carcinoma and its Prognosis
Document Type
Academic Journal
Source
临床放射学杂志 / Journal of Clinical Radiology. 43(3):388-393
Subject
Language
Chinese
ISSN
1001-9324
Abstract
目的 探讨钆塞酸二钠(Gd-EOB-DTPA)增强MRI 预测肝细胞癌(HCC)细胞角蛋白19(CK19)表达状态的应用价值,并评估CK19 阳性与CK19 阴性HCC患者根治性切除术后的预后.方法 回顾性分析行肝切除术的单发HCC患者的MRI和临床病理资料.评估MRI定性、定量特征及临床病理特征与CK19 阳性表达的相关性.多因素Logistic回归筛选出CK19 阳性HCC的独立预测因素.通过受试者工作特征曲线分析评估 CK19 表达的预测效能.使用Kaplan-Meier方法评估无复发生存率.结果 共纳入 137 例患者(CK19 阴性组 105 例,CK19 阳性组32 例).动脉期环状高强化、肝胆期肿瘤与肝实质信号强度比(SR)、DWI或HBP靶征和甲 胎 蛋 白(AFP)与CK19 阳性HCC相关(P<0.05).多因素分析示动脉期环状高强化和AFP>400 U/ml是CK19 阳性HCC的独立预测因素.联合上述两个指标预测CK19 阳性HCC的曲线下面积为0.750,敏感度为 72.4%,特异度为 75.9%.与CK19 阴性HCC患者相比,CK19 阳性 HCC 患者在肝切除后的无复发生存率(RFS)较低(1 年 RFS 65.5%vs 81.4%,2 年RFS 51.0%vs 65.9%),但两者差异无显著统计学意义(log-rank P =0.164).结论 动脉期环状高强化和AFP水平有助于术前预测CK19 阳性HCC,在根治性切除术后CK19 阳性HCC更易早期复发(2 年内).
Objective To investigate the value of Gd-EOB-DTPA enhanced MRI in predicting the expression of cytok-eratin 19(CK19)in hepatocellular carcinoma(HCC),and to evaluate the prognosis of patients with CK19 positive HCC and patients with CK19 negative HCC after radical resection.Methods MRI and clinicopathological data of HCC patients undergoing hepatectomy were analyzed retrospectively.To evaluate the correlation between MRI qualitative、quantitative in-dicator,clinicopathological characteristics and CK19 positive expression.Multivariate logistic regression was used to identify independent predictors of CK19 positive HCC.The predictive efficacy of CK19 expression was evaluated by analyzing the working characteristic curve of subjects.Kaplan-Meier method was used to evaluate relapse free survival.Results Totally 137 patients were included(105 in CK19 negative group and 32 in CK19 positive group).CK19 positive HCC was correla-ted with arterial rim enhancement,tumor-to-liver signal intensity ratio(SR)on hepatobiliary phase,DWI or HBP target sign and alpha fetoprotein(AFP)(P<0.05).Multivariate analysis showed arterial rim enhancement and AFP>400 IU/ml were independent predictors of CK19 positive HCC.The area under the curve of CK19 positive HCC predicted by combi-ning the above two indicators was 0.750,the sensitivity was 72.4% ,and the specificity was 75.9% .Compared with CK19 negative HCC patients,the recurrence free survival(RFS)of CK19 positive HCC patients after hepatectomy was lower(65.5% vs81.4% at 1 year,51.0% vs 65.9% at two years),but there was no significant difference between the two groups(log-rank P =0.164).Conclusion arterial rim enhancement and AFP level in arterial phase are helpful to pre-dict CK19 positive HCC before operation,and CK19 positive HCC is more likely to early recurrence(<2 years)after radi-cal resection.
Objective To investigate the value of Gd-EOB-DTPA enhanced MRI in predicting the expression of cytok-eratin 19(CK19)in hepatocellular carcinoma(HCC),and to evaluate the prognosis of patients with CK19 positive HCC and patients with CK19 negative HCC after radical resection.Methods MRI and clinicopathological data of HCC patients undergoing hepatectomy were analyzed retrospectively.To evaluate the correlation between MRI qualitative、quantitative in-dicator,clinicopathological characteristics and CK19 positive expression.Multivariate logistic regression was used to identify independent predictors of CK19 positive HCC.The predictive efficacy of CK19 expression was evaluated by analyzing the working characteristic curve of subjects.Kaplan-Meier method was used to evaluate relapse free survival.Results Totally 137 patients were included(105 in CK19 negative group and 32 in CK19 positive group).CK19 positive HCC was correla-ted with arterial rim enhancement,tumor-to-liver signal intensity ratio(SR)on hepatobiliary phase,DWI or HBP target sign and alpha fetoprotein(AFP)(P<0.05).Multivariate analysis showed arterial rim enhancement and AFP>400 IU/ml were independent predictors of CK19 positive HCC.The area under the curve of CK19 positive HCC predicted by combi-ning the above two indicators was 0.750,the sensitivity was 72.4% ,and the specificity was 75.9% .Compared with CK19 negative HCC patients,the recurrence free survival(RFS)of CK19 positive HCC patients after hepatectomy was lower(65.5% vs81.4% at 1 year,51.0% vs 65.9% at two years),but there was no significant difference between the two groups(log-rank P =0.164).Conclusion arterial rim enhancement and AFP level in arterial phase are helpful to pre-dict CK19 positive HCC before operation,and CK19 positive HCC is more likely to early recurrence(<2 years)after radi-cal resection.