摘要
目的探讨超声造影联合血清血管内皮生长因子(VEGF)、肝细胞生长因子(HGF)水平、C反应蛋白(CRP)/白蛋白(Alb)比值评估肝癌经导管动脉化疗栓塞术后(TACE)疗效价值。方法选取2017年10月~2019年10月期间来我院行TACE治疗的肝癌患者84例进行回顾性分析。根据实体瘤疗效评价标准,将治疗后一个月的患者分成疗效良好组和疗效不良组,每组分别为52例、32例。所有患者皆行超声造影检查,比较两组患者治疗前后的血清VEGF、HGF水平及CRP/Alb比值,采用受试者工作特征(ROC)曲线分析血清VEGF、HGF水平、CRP/Alb比值对肝癌TACE治疗疗效的评估价值。结果在治疗前,所有患者经超声造影检查均显示血供丰富,增强模式为“快进快出型”;经过TACE治疗后1个月,复查超声造影发现84个坏死病灶边缘清晰。疗效良好组患者在治疗后血清VEGF、HGF水平显著低于治疗前(P<0.05);而疗效不良组治疗后的血清CRP水平及CRP/Alb值显著高于治疗前,而VEGF、Alb水平显著低于治疗前(P<0.05)。在治疗后,疗效良好组的VEGF、HGF、CRP水平及CRP/Alb值显著低于疗效不良组,而Alb水平显著高于疗效不良组(P<0.05)。VEGF、HGF水平、CRP/Alb比值及联合检测的曲线下面积分别为0.927、0.938、0.861及0.947,最佳临界值分别为378.535 mg/L、89.585 g/L、0.625级568.261,敏感度分别为90.6%、96.9%、29.4%及98.4%,特异度分别为92.3%、86.5%、100.0%及87.9%。结论超声造影、血清VEGF、HGF水平、CRP/Alb比值可以作为评估肝癌TACE治疗疗效的重要指标,且四者联合评估有利于进一步提高疗效评估价值。
Objective To explore the value of contrast-enhanced ultrasound combined with serum vascular endothelial growth factor(VEGF),hepatocyte growth factor(HGF)level,and C-reactive protein(CRP)/albumin(Alb)ratio to evaluate the efficacy of transcatheter arterial chemoembolization(TACE)for liver cancer.Methods A retrospective analysis was performed on 84 patients with liver cancer who were treated with TACE in our hospital from October 2017 to October 2019.According to the evaluation criteria for the efficacy of solid tumors,patients one month after treatment were divided into good curative groups and poor curative groups,with 52 and 32 in each group.All patients underwent contrast-enhanced ultrasonography.Serum VEGF,HGF levels,and CRP/Alb ratios were compared between the two groups of patients before and after treatment.The receiver operating characteristic(ROC)curve was used to analyze serum VEGF,HGF levels,and CRP/Alb ratios for liver cancer TACE.Treatment efficacy was evaluated.Results Before treatment,all patients showed rich blood supply by contrast-enhanced ultrasound,and the enhancement mode was"fast-forward and fast-exit".One month after TACE treatment,the contrast-enhanced ultrasound revealed 84 necrotic lesions with clear edges.The serum VEGF and HGF levels of patients in the good-effect group were significantly lower than those before treatment(P<0.05);the serum CRP levels and CRP/Alb values of the poor-effect group were significantly higher than those before treatment,while the levels of VEGF and Alb were significantly higher.It was lower than before treatment(P<0.05).After treatment,the levels of VEGF,HGF,CRP,and CRP/Alb in the group with good effect were significantly lower than those in the group with poor effect,and the levels of Alb were significantly higher than those in the group with poor effect(P<0.05).VEGF,HGF level,CRP/Alb ratio and the area under the curve of the combined detection were 0.927,0.938,0.861,and 0.947,the best cutoffs were 378.535 mg/L,89.585 g/L,0.625 grade 568.261,and the sensitivity was 90.6%,96.9%,29.4%,and 98.4%,with specificities of 92.3%,86.5%,100.0%,and 87.9%,respectively.Conclusion Contrast-enhanced ultrasound,serum VEGF,HGF levels,and CRP/Alb ratios can be used as important indicators for evaluating the efficacy of TACE treatment of liver cancer,and the combined evaluation of the four is conducive to further improving the value of efficacy evaluation.
作者
宣之东
秦悦
武娜
XUAN Zhidong;QIN Yue;WU Na(Department 3 of ultrasound,Cangzhou Central Hospital,Cangzhou 061001,P.R.China)
出处
《医学影像学杂志》
2020年第10期1850-1854,共5页
Journal of Medical Imaging
关键词
超声造影
血管内皮生长因子
肝细胞生长因子
C反应蛋白/白蛋白比值
肝癌
经导管动脉化疗栓塞术
Contrast-enhanced ultrasound
Vascular endothelial growth factor
Hepatocyte growth factor
C-reactive protein/albumin ratio
Liver cancer
Transcatheter arterial chemoembolization
