摘要
目的:探讨核磁共振成像(MRI)联合血清SCL/TALI断裂点(STIL)、簇集素(Clusterin)在原发性肝癌介入术后疗效评估的临床价值。方法:选取2020年6月至2023年6月进行肝动脉化疗栓塞术的原发性肝癌患者80例,以数字减影血管造影作为评估患者术后疗效的“金标准”,将其分为复发组(57例)和未复发组(23例)。比较两组患者血清STIL、Clusterin的水平,采用ROC曲线分析血清STIL、Clusterin对原发性肝癌介入术后疗效评估的价值,四格表法分析MRI联合血清STIL、Clusterin对患者术后疗效的评估。结果:复发组患者血清STIL、Clusterin水平高于未复发组(P<0.05);血清STIL、Clusterin对原发性肝癌介入术后疗效评估的AUC分别为0.738、0.744,最佳截断值分别为36.32 ng/ml、85.25μg/ml;MRI检查结果显示原发性肝癌介入术后复发的45例,未复发35例;MRI评估原发性肝癌介入术后疗效的敏感性为70.18%,特异性为78.26%,准确率为72.50%;MRI联合血清STIL、Clusterin评估原发性肝癌介入术后疗效的准确率为90.00%,敏感性为94.74%,特异性为78.26%,三者联合对原发性肝癌介入术后疗效评估的准确率和敏感性显著高于各指标单独评估(P<0.05)。结论:原发性肝癌介入术后复发患者血清STIL、Clusterin水平显著上调,MRI联合血清STIL、Clusterin对原发性肝癌介入术后疗效的评估具有较高的临床价值。
Objective:Exploring the clinical value of magnetic resonance imaging(MRI)combined with serum SCL/TALI breakpoint(STIL)and clusterin in the assessment of efficacy after primary liver cancer intervention.Methods:Eighty patients with primary liver cancer who underwent hepatic artery chemoembolization from June 2020 to June 2023 were selected,and digital silhouette angiography was used as the“gold standard”for evaluating the efficacy of the patients after intervention,and they were divided into the recurrence group(57 cases)and the non-recurrence group(23 cases).We compared the levels of serum STIL and Clusterin between the two groups,used ROC curve to analyze the value of serum STIL and Clusterin in the assessment of post-interventional efficacy of primary liver cancer,analyzed the results of MRI,and analyzed the assessment of postoperative efficacy of patients by MRI combined with serum STIL and Clusterin using the four-compartmental table method.Results:Serum STIL and Clusterin levels were higher in the recurrence group than in the non-recurrence group(P<0.05).The AUCs of serum STIL and Clusterin for the assessment of the efficacy of primary hepatocellular carcinoma after intervention were 0.738 and 0.744,respectively,and the optimal cutoff values were 36.32 ng/mL and 85.25μg/mL,respectively.The results of the MRI examination showed that primary hepatocellular carcinoma recurrence after intervention in 45 cases and no recurrence in 35 cases;the sensitivity o25f MRI in assessing the efficacy of primary liver cancer after intervention was 70.18%,the specificity was 78.26%,and the accuracy was 72.50%.The accuracy of MRI combined with serum STIL and Clusterin in assessing the efficacy of primary liver cancer after intervention was 90.00%,the sensitivity was 94.74%,the specificity was 78.26%,and the accuracy and sensitivity of the three combined for the assessment of post-interventional efficacy of primary hepatocellular carcinoma were significantly higher than those of each index alone(P<0.05).Conclusion:Serum STIL and Clusterin levels were significantly up-regulated in patients with recurrence after primary hepatocellular carcinoma intervention,and MRI combined with serum STIL and Clusterin is of high value in assessing the efficacy of primary hepatocellular carcinoma after intervention.
作者
徐征
吴瑛
邓冬平
XU Zheng;WU Ying;DENG Dong-ping(Radiology Intervention Department,First People's Hospital of Huzhou City(Huzhou Zhejiang,313000),China)
出处
《中西医结合肝病杂志》
2025年第2期222-225,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
湖州市科学技术项目(No.2023GYB29)。
