| 杨瑞静,马蕾,胡妞妞,刘红明,陈如诗,任晓转.能谱CT参数联合GPC3及内皮糖蛋白评估肝癌微血管侵犯并分析术后3年死亡影响因素[J].中国医学影像技术,2026,42(3):361~365 |
| 能谱CT参数联合GPC3及内皮糖蛋白评估肝癌微血管侵犯并分析术后3年死亡影响因素 |
| Spectral CT parameters combined with GPC3 and endoglin for evaluating microvascular invasion of liver cancer and analyzing impact factors of 3-year postoperative mortality |
| 投稿时间：2025-10-29 修订日期：2026-02-09 |
| DOI：10.13929/j.issn.1003-3289.2026.03.009 |
| 中文关键词: 肝肿瘤 体层摄影术,X线计算机 微血管侵犯 |
| 英文关键词:liver neoplasms tomography,X-ray computed microvascular invasion |
| 基金项目:河南省医学科技攻关计划(LHGJ20220061)。 |
|
| 摘要点击次数: 65 |
| 全文下载次数: 52 |
| 中文摘要: |
| 目的 观察能谱CT参数联合磷脂酰肌醇蛋白聚糖3(GPC3)及内皮糖蛋白评估肝癌微血管侵犯(MVI)的价值,分析术后3年死亡的影响因素。方法 回顾性纳入204例肝癌,根据术后病理分为MVI(n=113)与非MVI组(n=91);比较组间临床资料及能谱CT参数;以受试者工作特征曲线下面积(AUC)分析GPC3、内皮糖蛋白及组间差异有统计学意义的能谱CT参数评估肝癌MVI的效能;采用单因素及多因素Cox回归分析筛选肝癌术后3年死亡的独立影响因素。结果 MVI组肝硬化占比、Child-Pugh B级占比、甲胎蛋白(AFP)、癌胚抗原(CEA)、GPC3、内皮糖蛋白水平、动脉期(AP)-碘浓度(IC)(AP-IC)、AP-标准IC(AP-NIC)及AP-有效原子序数(AP-Zeff)均高于非MVI组(P均＜0.05)。GPC3、内皮糖蛋白、AP-IC、AP-NIC及AP-Zeff联合评估肝癌MVI的AUC为0.938,高于各单一指标(AUC分别为0.774、0.791、0.712、0.808、0.749,P均＜0.05)。MVI组术后3年死亡率高于非MVI组[48.67%(55/113) vs. 24.18%(22/91),P＜0.05]。肝硬化、Child-Pugh分级、AFP、CEA、GPC3、内皮糖蛋白、AP-NIC及肿瘤跨叶生长均为肝癌术后3年死亡的独立影响因素(P均＜0.05)。结论 能谱CT参数联合GPC3及内皮糖蛋白可有效评估肝癌MVI;肝癌术后3年死亡的影响因素包括肝硬化、Child-Pugh分级、AFP、CEA、GPC3、内皮糖蛋白、AP-NIC及肿瘤跨叶生长。 |
| 英文摘要: |
| Objective To observe the value of spectral CT parameters combined with glypican-3 (GPC3) and endoglin for evaluating microvascular invasion (MVI) of liver cancer, and to analyze the impact factors of 3-year postoperative mortality. Methods Totally 204 patients with liver cancer were retrospectively enrolled and divided into MVI group (n=113) and non-MVI group (n=91) according to postoperative pathological findings. Clinical data and spectral CT parameters were compared between groups. The efficacy of GPC3, endoglin and spectral CT parameters being significantly different between groups for evaluating MVI of liver cancer were assessed using the area under the receiver operating characteristic curves (AUC). Univariate and multivariate Cox regression analyses were performed to screen independent impact factors for 3-year mortality after liver cancer surgery. Results The proportion of liver cirrhosis, Child-Pugh grade B, the levels of alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA), GPC3, endoglin, arterial phase (AP)-iodine concentration (IC) (AP-IC), AP-normalized IC (AP-NIC) and AP-effective atomic number (AP-Zeff) in MVI group were all higher than those in non-MVI group (all P＜0.05). AUC of combination of GPC3, endoglin, AP-IC, AP-NIC and AP-Zeff for evaluating MVI of liver cancer was 0.938, higher than that of each single index (AUC=0.774, 0.791, 0.712, 0.808 and 0.749, respectively, all P＜0.05). The 3-year postoperative mortality rate in MVI group was higher than that in non-MVI group (48.67%[55/113] vs. 24.18%[22/91], P＜0.05). Liver cirrhosis, Child-Pugh grading, AFP, CEA, GPC3, endoglin, AP-NIC and tumor growth across lobes were all independent impact factors for 3-year mortality after liver cancer surgery (all P＜0.05). Conclusion Spectral CT parameters combined with GPC3 and endoglin could effectively evaluate MVI of liver cancer. Liver cirrhosis, Child-Pugh grading, AFP, CEA, GPC3, endoglin, AP-NIC and tumor growth across lobes were all impact factors for death within 3 years after surgical resection of liver cancer. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
