摘要
目的探讨超声造影鉴别诊断胆管细胞癌与肝细胞癌的价值。方法选取我院经病理确诊的42例胆管细胞癌患者(胆管细胞癌组)与114例肝细胞癌患者,其中肝细胞癌患者按照不同分化程度分为高分化组、中分化组、低分化组,每组各38例。各组均行超声造影检查获得始增时间、达峰时间、始退时间、持续时间、始增强度及峰值强度;行免疫组化检测获得微血管密度(MVD);比较各组上述参数差异。应用Pearson相关分析法分析超声造影参数与MVD的关系;绘制受试者工作特征(ROC)曲线分析各超声造影参数鉴别诊断胆管细胞癌与肝细胞癌的效能。结果胆管细胞癌组始增时间、峰值强度均高于高、中、低分化组(均P<0.05);胆管细胞癌组达峰时间与高、中分化组比较,差异均无统计学意义;胆管细胞癌组达峰时间高于低分化组(P<0.05),始退时间、持续时间、MVD均低于高、中、低分化组(均P<0.05)。胆管细胞癌组始增强度与高、中、低分化组比较,差异均无统计学意义。相关性分析显示,达峰时间、峰值强度与MVD均呈负相关(均P<0.05);持续时间、始增强度与MVD均呈正相关(均P<0.05)。ROC曲线分析显示,始增时间、达峰时间、始退时间、持续时间、始增强度、峰值强度及其联合应用鉴别诊断胆管细胞癌与肝细胞癌的曲线下面积分别为0.695、0.799、0.655、0.624、0.635、0.639、0.995,联合应用的AUC高于各参数单独应用(均P<0.05)。结论超声造影可有效鉴别胆管细胞癌与肝细胞癌,为临床治疗提供客观依据。
Objective To explore the value of contrast-enhanced ultrasound in the differential diagnosis of cholangiocarcinoma and hepatocellular carcinoma.Methods The clinical data of 42 patients with cholangiocarcinoma(cholangiocarcinoma group)and 114 patients with hepatocellular carcinoma diagnosed by pathology were retrospectively analyzed.The patients with hepatocellular carcinoma were divided into well-,medium-and poorly-differentiated group according to different degrees of differentiation,with 38 cases in each group.All groups underwent contrast-enhanced ultrasound examination to obtain the initial increase time,peak time,initial regression time and duration,immunohistochemical detection was performed to obtain microvessel density(MVD),the differences of above parameters were analyzed.Pearson correlation analysis method was used to analyze the relationship between contrast-enhanced ultrasound parameters and MVD.ROC curve was drawn to analyze the efficacy of each contrast-enhanced ultrasound parameters in the differential diagnosis of cholangiocarcinoma and hepatocellular carcinoma.Results The initial increase time and peak intensity of cholangiocarcinoma group were higher than those of well-,medium-and poorly-differentiated groups(all P<0.05).There were no statistically significant difference in the peak time of cholangiocarcinoma group compared with the well-and medium-differentiated groups.The peak time of cholangiocarcinoma group was higher than that of poorly differentiated group(P<0.05).The initial regression time,duration,and MVD of the cholangiocarcinoma group were lower than those of the well-,medium-and poorly-differentiated groups(all P<0.05).There was no statistically significant difference in the initial enhancement between the cholangiocarcinoma group and well-,medium-and poorly differentiated groups.Correlation analysis showed that peak time and peak intensity were negatively correlated with MVD(both P<0.05),duration and initial enhancement were positively correlated with MVD(both P<0.05).ROC curve analysis showed that the area under the curve of initial increase time,peak time,initial regression time,duration,initial enhancement,peak intensity,and their combination for differential diagnosis of cholangiocarcinoma and hepatocelluar carcinoma were 0.695,0.799,0.655,0.624,0.635,0.639,0.995,respectively.The area under the curve of combined application was higher than that of each parameter alone(all P<0.05).Conclusion Contrast-enhanced ultrasound can distinguish cholangiocarcinoma from hepatocellular carcinoma which can provide an objective basis for clinical treatment.
作者
洪德娜
朱桂新
张敬红
李冰
HONG Dena;ZHU Guixin;ZHANG Jinghong;LI Bing(Department of Ultrasound,Chaoyang Central Hospital,Liaoning 122000,China)
出处
《临床超声医学杂志》
CSCD
2021年第9期679-683,共5页
Journal of Clinical Ultrasound in Medicine
关键词
超声检查
造影剂
胆管细胞癌
肝细胞癌
微血管密度
Ultrasonography
Contrast agent
Cholangiocarcinoma
Hepatocellular carcinoma
Microvessel density
