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二维剪切波弹性成像测量肝硬度值在原发性乙肝病毒阳性肝细胞癌射频消融术后的预后价值

Prognosis value of liver stiffness measurements by 2D-SWE in primary HBV-positive hepatocellular carcinoma following radiofrequency ablation.

作者信息

Xie Xinxin, Yu Yongqiang

机构信息

Ultrasound Department, The First Affiliated Hospital of Anhui Medical University, Hefei 230000, China.

Radiology Department, The First Affiliated Hospital of Anhui Medical University, Hefei 230000, China.

出版信息

Transl Cancer Res. 2020 Apr;9(4):2518-2526. doi: 10.21037/tcr.2020.03.04.

Abstract

BACKGROUND

Liver fibrosis is closely associated with the occurrence of hepatocellular carcinoma (HCC), which can be evaluated by liver stiffness measurements (LSM). The clinical significance of LSMin patient with hepatitis B virus (HBV) related HCC underwent radiofrequency ablation (RFA) was evaluated.

METHODS

Total of 273 patients underwent RFA for primary HBV-positive HCC were included. LSM values were measured by using by 2D-shear wave elastography (2D-SWE) prior to RFA. The relationship between pretreatment LSM value and survival outcome was evaluated. The cutoff value for LSM to predict survival outcome was determined by receiver operating characteristic (ROC) curve analysis.

RESULTS

At the endpoint of this study, 88 (32.2%) and 73 (26.7%) patients out of all 273 patients studied had died and recurrent, respectively. All patients were divided into two groups based on the cutoff value (13.4 kPa) of LSM. Patients with a LSM ≥13.4 kPa had lower mean overall survival (62.5 48.5 months, P=0.01) and lower recurrent free survival (60.4 47.3 months, P=0.02) than patients with a LSM <13.4 kPa in univariate analysis and LSM also been evaluated as independent predictive factor for survival outcome for HCC following RFA. Otherwise, LSM also was related to liver cirrhosis and TNM stage (both P<0.05).

CONCLUSIONS

LSM measured by 2D-SWE can sever as an independent prognostic indictor for patients undergoing RFA for HBV-positive HCC.

摘要

背景

肝纤维化与肝细胞癌(HCC)的发生密切相关,可通过肝脏硬度测量(LSM)进行评估。本研究评估了LSM在接受射频消融(RFA)的乙型肝炎病毒(HBV)相关HCC患者中的临床意义。

方法

纳入273例接受RFA治疗的原发性HBV阳性HCC患者。在RFA治疗前,采用二维剪切波弹性成像(2D-SWE)测量LSM值。评估治疗前LSM值与生存结局的关系。通过受试者操作特征(ROC)曲线分析确定LSM预测生存结局的临界值。

结果

在本研究终点时,273例研究患者中分别有88例(32.2%)和73例(26.7%)死亡和复发。根据LSM临界值(13.4 kPa)将所有患者分为两组。在单因素分析中,LSM≥13.4 kPa的患者的平均总生存期(62.5对48.5个月,P=0.01)和无复发生存期(60.4对47.3个月,P=0.02)均低于LSM<13.4 kPa的患者,LSM也被评估为RFA术后HCC生存结局的独立预测因素。此外,LSM还与肝硬化和TNM分期相关(均P<0.05)。

结论

二维剪切波弹性成像测量的LSM可作为HBV阳性HCC患者接受RFA治疗的独立预后指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93a0/8798438/e96ccfbe3f9e/tcr-09-04-2518-f1.jpg

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