Boryczka Grzegorz, Hartleb Marek, Janik Małgorzata
Department of Gastroenterology and Hepatology, School of Medicine, Medical University of Silesia, Katowice, Poland.
Department of Biomedical Computer Systems, Institute of Informatics in Sosnowiec, University of Silesia, Sosnowiec, Poland.
Prz Gastroenterol. 2018;13(1):40-46. doi: 10.5114/pg.2018.74561. Epub 2018 Mar 26.
Diagnosis of hepatocellular carcinoma (HCC) is considerably delayed, being frequently done in the non-curative stage of disease. The reason for delayed diagnosis is indolent course in early stages and/or unspecific symptoms indistinguishable from underlying cirrhosis. Hitherto methods used for screening of HCC have important limitations. TRIMprob is a non-invasive method, which showed utility in detection of cancers located in prostate, breast, or urinary bladder.
To determine the diagnostic accuracy of TRIMprob in detecting HCC in cirrhotic liver.
Forty-five patients were prospectively enrolled according to final clinical diagnosis into a group of cirrhosis and HCC or a group of cirrhosis without HCC. A control group consisted of 33 healthy subjects. Hepatocellular carcinoma was diagnosed by computed tomography (CT) or magnetic resonance (MR) and guided biopsy. The TRIMprob examination was performed in each patient. Three wave frequencies were used: 465, 930, and 1395 MHz.
In patients with HCC the intensity of return signal using wave a frequency of 465 MHz was significantly reduced in patients with HCC in comparison to healthy subjects ( < 0.0005), but not to cirrhotic patients without HCC. Moreover, cirrhosis was associated with significantly decreased TRIMprob signal in comparison to healthy liver ( < 0.002). In ROC analysis an optimal cut-off value for detection of HCC was 106 units, which yielded 80% sensitivity.
TRIMprob identifies HCC with good sensitivity; however, the accuracy of this method to identify HCC in screening circumstances may be hindered by attenuation of the resonance interaction signal by cirrhosis itself.
肝细胞癌（HCC）的诊断被显著延迟，常常在疾病的非治愈阶段才得以进行。诊断延迟的原因是早期病程隐匿和/或症状不具特异性，与潜在的肝硬化难以区分。迄今为止，用于筛查HCC的方法存在重要局限性。TRIMprob是一种非侵入性方法，已显示出在检测前列腺癌、乳腺癌或膀胱癌方面的效用。
确定TRIMprob在检测肝硬化肝脏中HCC的诊断准确性。
根据最终临床诊断，前瞻性纳入45例患者，分为肝硬化合并HCC组或无HCC的肝硬化组。对照组由33名健康受试者组成。通过计算机断层扫描（CT）或磁共振成像（MR）及引导下活检诊断肝细胞癌。对每位患者进行TRIMprob检查。使用了三个波频率：465、930和1395兆赫。
与健康受试者相比，HCC患者使用465兆赫波频率时的回波信号强度显著降低（<0.0005），但与无HCC的肝硬化患者相比则不然。此外，与健康肝脏相比，肝硬化与TRIMprob信号显著降低相关（<0.002）。在ROC分析中，检测HCC的最佳截断值为106单位，灵敏度为80%。
TRIMprob能以良好的灵敏度识别HCC；然而，在筛查情况下，该方法识别HCC的准确性可能会受到肝硬化本身对共振相互作用信号的衰减的阻碍。
