| 李娟,郑佳利,路秋晨,等.超声造影肝脏影像报告和数据管理系统分类联合血清热休克蛋白 90α、异常凝血酶原鉴别肝细胞癌和肝内胆管细胞癌[J].安徽医药,2023,27(6):1126-1129. |
| 超声造影肝脏影像报告和数据管理系统分类联合血清热休克蛋白 90α、异常凝血酶原鉴别肝细胞癌和肝内胆管细胞癌 |
| Contrast-enhanced ultrasound liver imaging reporting and data system classification combined with serum heat shock protein 90α and protein induced by vitamin K absence or antagonist-Ⅱ in differentiating hepatocellular carcinoma and intrahepatic cholangiocarcinoma |
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| DOI：10.3969/j.issn.10096469.2023.06.015 |
| 中文关键词: 超声检查 胆管，肝内 癌，肝细胞 血管造影术 超声造影 肝脏影像报告和数据管理系统 热休克蛋白 90α 异常凝血酶原 肝内胆管细胞癌 诊断 |
| 英文关键词: Ultrasonography Bile ducts, intrahepatic Carcinoma, hepatocellular Angiography Contrast-enhanced ultrasound Liver imaging reporting and data system Heat shock protein 90α Protein induced by vitamin K absence or antagonist-Ⅱ Intrahepatic cholangiocarcinoma Diagnosis |
| 基金项目:四川省卫生健康委员会科研课题( 19PJ115)；绵阳市卫生健康委员会医学科研课题( 202112) |
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| 中文摘要: |
| 目的探讨血清热休克蛋白 90α(HSP90α)异常凝血酶原(PIVKA-Ⅱ)联合超声造影肝脏影像报告和数据管理系统(LIRADS)分类在肝细胞癌和肝内胆管细胞癌中的鉴别诊、断价值。方法选取绵阳市中心医院 2020年 5月至 2021年 11月确诊的 35例肝内胆管细胞癌( ICC)病人为 ICC组，另选取 105例肝细胞癌病人为肝细胞癌组。采用全自动发光免疫分析仪检测血清 PIVKA-Ⅱ水平，采用 ELISA法检测血清 HSP90α水平，对所有病人进行超声造影检查，根据 LI-RADS分类系统收集各超声特征；受试者操作特征(ROC)曲线分析超声造影 LI-RADS-M(简称 LR-M)类特征(动脉期环状高增强、门脉早期消退、显著消退)、血清 HSP90α、PIVKA-Ⅱ及三者联合诊断 ICC的价值。结果与肝细胞癌组［( 8.89±1.63)μg/L，(526.18±83.75)mAU/mL，16.19%，10.48%，15.24%，6.67%，48.57%，21.90%］相比， ICC组血清 HSP90α(12.15±2.56)μg/L、PIVKA-Ⅱ(679.42±95.74)mAU/mL水平及胆管扩张( 60.00%)肿瘤边界模糊(60.00%)形态不规则(62.86%)、动脉期环状高增强(51.43%)、门脉早期消退(94.29%)、显著著较高( P<0.05)。超影 LR-M类特征、血清 HSP90α、PIVKA-Ⅱ及三者联合诊断 ICC的曲线下面积(AUC)及其 95%CI分别为 0.80(0.72，0.88)、 0.78(0.71，0.90)、 0.78(0.68，0.87)、 0.90(0.82，0.98)其中联合诊断效能最佳。结论消退(65.71%)比例显、声造、 |
| 英文摘要: |
| Objective To investigate the differential diagnostic value of serum heat shock protein 90α (HSP90α) and protein inducedby vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ) combined with contrast-enhanced ultrasound liver imaging reporting and data system (LI-RADS) classification in hepatocellular carcinoma and intrahepatic cholangiocarcinoma.Methods Thirty-five patients with intrahepatic cholangiocarcinoma (ICC) diagnosed in Mianyang Central Hospital from May 2020 to November 2021 were collected as the ICCgroup, and another 105 patients with hepatocellular carcinoma were collected as the hepatocellular carcinoma group. The serum PIVKAⅡ level was measured by automatic luminescence immunoassay, and the serum HSP90α level was measured by ELISA, contrast-enhanced ultrasound was performed on all patients, and the ultrasound characteristics were collected according to the LI-RADS classification system; receiver operating characteristic (ROC) curve was performed to analyze the value of CEUS LI-RADS-M (abbreviated as LRM) features (circular hyperenhancement in arterial phase, early regression of portal vein, significant regression), serum HSP90α, PIVKAⅡ , and their combination in the diagnosis of ICC. Results Compared with the hepatocellular carcinoma group [(8.89±1.63)μg/L,(526.18±83.75) mAU/mL, 16.19%, 10.48%, 15.24%, 6.67%, 48.57%, 21.90%], the serum HSP90α (12.15±2.56) μg/L, PIVKA-Ⅱ (679.42±95.74) mAU/mL, bile duct dilatation (60.00%), blurred tumor boundary (60.00%), irregular shape (62.86%), annular hyperenhancement in the arterial phase (51.43%), early regression of the portal vein (94.29 %), and significant regression ratio (65.71%) weresignificantly higher in the ICC group (P<0.05). The areas under the curve (AUC) and its 95%CI of CEUS LR-M features, serum HSP90α, PIVKA-Ⅱ and their combination in the diagnosis of ICC were 0.80 (0.72, 0.88), 0.78 (0.71, 0.90), 0.78 (0.68, 0.87), 0.90 (0.82, 0.98), respectively, among which the combined diagnostic efficiency was the best. Conclusion CEUS LR-M features combined with serum HSP90α and PIVKA-Ⅱ has high diagnostic performance for ICC, and can effectively differentiate hepatocellular carcinoma from ICC. |
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