摘要
目的探究新型可视化瞬时弹性成像(ViTE)和肝脂肪变定量分析(LiSA)技术在评估肝癌合并乙肝患者消融术后肝功能损伤中的价值。方法回顾性分析2022年1月至2023年8月于哈尔滨医科大学附属肿瘤医院行消融治疗的肝癌合并乙肝患者129例。患者术前均进行ViTE和LiSA检查,并记录肝脏硬度E值和LiSA值。构建白蛋白-胆红素(ALBI)评分,并采用Spearman相关分析法分析E值、LiSA值与ALBI评分、体质指数(BMI)的相关性。根据围手术期ALBI分级变化,将患者分为肝功能无变化组和肝功能损伤组。采用单因素和多因素分析方法分析影响消融术后肝功能变化的相关因素,并建立预测模型。结果Spearman相关分析结果显示E值与ALBI评分呈强正相关(rs=0.686,P<0.001),LiSA值与BMI呈弱正相关(rs=0.338,P<0.001),而E值与BMI、LiSA值与ALBI评分无显著相关性(均P>0.05)。单因素分析结果显示两组间年龄、BMI、消融参数、E值、LiSA值差异有统计学意义(均P<0.05)。多因素分析结果显示E值、LiSA值和消融时间是消融术后肝功能损伤的独立预测因子(均P<0.05)。基于多因素分析结果建立消融术后肝功能损伤预测模型,ROC曲线下面积为0.892,具有较高的准确性(82.9%)。结论在实时超声引导下,基于ViTE和LiSA技术建立的无创性肝功能损伤预测模型可为肝癌合并乙肝患者消融围手术期肝功能变化提供个性化预测。
Objective To investigate the value of a novel technique called visual transient elastography(ViTE)and liver steatosis analysis(LiSA)in assessing liver function injury in hepatitis B virus-related hepatocellular carcinoma(HBV-related HCC)patients after ablation therapy.Methods A total of 129 HBV-related HCC patients in Harbin Medical University Cancer Hospital from January 2022 to August 2023 were retrospectively analyzed.ViTE and LiSA examinations were applied to record the liver stiffness E value and LiSA value before ablation.An albumin-bilirubin(ALBI)score was constructed using laboratory indicators.Spearman correlation analysis was used to assess the correlation between E value,LiSA value and ALBI score,body mass index(BMI).According to the change of ALBI grade in perioperative period,the patients could be divided into two groups:liver function unchanged group and liver function injury group.Univariate and multivariate statistical methods were used to analyze related factors affecting changes in liver function after ablation,followed by establishing a predictive model.Results Spearman analysis showed a strong positive correlation between E value and ALBI score(rs=0.686,P<0.001),and LiSA value was weakly positively correlated with BMI(rs=0.338,P<0.001).There were no significant correlations between E value and BMI,LiSA value and ALBI score(all P>0.05).Univariate analysis showed that differences of age,BMI,ablation parameters,E value,and LiSA value in the two groups were statistically significant(all P<0.05).Multivariate analysis showed that E value,LiSA value,and ablation time were independent predictors of hepatic dysfunction after ablation(all P<0.05).AUC was 0.892 indicating high accuracy in the predictive model based on above indicators.Conclusions Under the real-time ultrasound guidance,a non-invasive liver function injury prediction model based on ViTE and LiSA technology can offer personalized predictions for ablative perioperative changes in liver function among HBV-related HCC patients.
作者
梁锡天
杨威
陈宇欣
陈余
韩雪
程文
Liang Xitian;Yang Wei;Chen Yuxin;Chen Yu;Han Xue;Cheng Wen(Department of Ultrasonography,Harbin Medical University Cancer Hospital,Harbin 150081,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2024年第3期209-215,共7页
Chinese Journal of Ultrasonography
基金
国家自然科学基金面上项目(82171947)
哈尔滨医科大学附属肿瘤医院海燕基金青年项目(JJQN2019-09)。
关键词
可视化瞬时弹性成像
肝脂肪变定量分析
肝细胞癌
乙肝
消融治疗
肝功能损伤
Visual transient elastography
Liver steatosis analysis
Hepatocellular carcinoma
Hepatitis B
Ablation therapy
Liver function injury
