定量对比增强超声在肝癌消融术后复发中的预测价值
Predictive value of quantitative contrast-enhanced ultrasound in hepatocellular carcinoma recurrence after ablation.
作者信息
Gao Yi, Zheng Dong-Yan, Cui Zheng, Ma Yan, Liu Yuan-Zhi, Zhang Wei
机构信息
Yi Gao, Zheng Cui, Yan Ma, Department of Ultrasound in Medicine, Tongji University Affiliated East Hospital, Shanghai 200120, China.
出版信息
World J Gastroenterol. 2015 Sep 28;21(36):10418-26. doi: 10.3748/wjg.v21.i36.10418.
AIM
To investigate the relationship between contrast-enhanced ultrasound (CEUS), basic fibroblast growth factor (bFGF), endothelin-1 (ET-1), and hepatocellular carcinoma (HCC) recurrence after ablation.
METHODS
A total of 51 HCC patients (38 males and 13 females) who received radiofrequency ablation in our hospital from June 2012 to July 2014 were enrolled in this study. The patients were divided into two groups: recurrence group and non-recurrence group. Routine abdominal examination was first performed in the horizontal position. Then the patients underwent CEUS and immunohistochemical staining before receiving radiofrequency ablation. All patients were followed-up every three months for one year. The results of CEUS and serum tumor marker levels were evaluated and combined together to estimate HCC recurrence and metastasis. Patients were divided into two groups: recurrence group and non-recurrence group. Quantitative parameters of CEUS and tumor expression levels of bFGF and ET-1 were compared between the two groups, respectively. Binary logistic regression analysis was used to analyze the relationship between CEUS quantitative parameters, expression levels of ET-1 and bFGF, and HCC recurrence after ablation.
RESULTS
Based on the quantitative parameters of CEUS before patients received radiofrequency ablation, the levels of tumor rise time (tRT), tumor time to peak (tTTP), tumor peak intensity (tPI) and tumor-parenchymal peak intensity (t-pPI) in the recurrence group were significantly lower than those in the non-recurrence group (16.6 ± 6.1 vs 23.2 ± 7.0, P = 0.000; 41.2 ± 10.2 vs 59.6 ± 14.2, P = 0.000; 23.8 ± 6.7 vs 31.4 ± 6.4, P = 0.000; 7.1 ± 3.4 vs 14.6 ± 7.4, P = 0.000; respectively). The expression levels of bFGF in the recurrence group were significantly higher than those in the non-recurrence group (P < 0.05). Levels of tTTP showed a significant inverse correlation with the level of bFGF in tumors (r = -0.312, P = 0.037). The Binary logistic regression analysis results revealed that the levels of tRT, tTTP, tPI and the level of bFGF were associated with HCC recurrence after radiofrequency ablation (P < 0.05).
CONCLUSION
CEUS is a noninvasive and effective method for evaluating the angiogenesis of HCC, and predicting its recurrence and prognosis.
目的
探讨超声造影（CEUS）、碱性成纤维细胞生长因子（bFGF）、内皮素-1（ET-1）与肝癌（HCC）消融术后复发的关系。
方法
选取2012年6月至2014年7月在我院接受射频消融治疗的51例HCC患者（男38例，女13例）。将患者分为两组：复发组和未复发组。首先在平卧位进行常规腹部检查。然后患者在接受射频消融前进行CEUS和免疫组织化学染色。所有患者每3个月随访1年。评估CEUS结果和血清肿瘤标志物水平，并综合评估HCC的复发和转移情况。将患者分为两组：复发组和未复发组。分别比较两组CEUS的定量参数以及bFGF和ET-1的肿瘤表达水平。采用二元逻辑回归分析CEUS定量参数、ET-1和bFGF表达水平与消融后HCC复发的关系。
结果
根据患者射频消融前CEUS的定量参数，复发组的肿瘤上升时间（tRT）、肿瘤达峰时间（tTTP）、肿瘤峰值强度（tPI）和肿瘤-实质峰值强度（t-pPI）水平均显著低于未复发组（分别为16.6±6.1 vs 23.2±7.0，P = 0.000；41.2±10.2 vs 59.6±14.2，P = 0.000；23.8±6.7 vs 31.4±6.4，P = 0.000；7.1±3.4 vs 14.6±7.4，P = 0.000）。复发组bFGF的表达水平显著高于未复发组（P < 0.05）。tTTP水平与肿瘤中bFGF水平呈显著负相关（r = -0.312，P = 0.037）。二元逻辑回归分析结果显示，tRT、tTTP、tPI水平以及bFGF水平与射频消融后HCC复发相关（P < 0.05）。
结论
CEUS是评估HCC血管生成、预测其复发和预后的一种无创且有效的方法。
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