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MRI联合血清凝集素反应性甲胎蛋白对经皮射频消融术后肝癌复发的预测价值

Predictive Value of MRI with Serum Lectin-Reactive Alpha-Fetoprotein for Liver Cancer Recurrence after Percutaneous Radiofrequency Ablation.

作者信息

Zhang Guangfeng, Yun Yongxing, Lin Chunming, Li Huafeng

机构信息

Radiology Department, Shenzhen Third People's Hospital, Shenzhen, China.

Endocrinology Department, South China Hospital Affiliated to Shenzhen University, Shenzhen, China.

出版信息

Evid Based Complement Alternat Med. 2022 Jul 19;2022:5132135. doi: 10.1155/2022/5132135. eCollection 2022.

Abstract

OBJECTIVE

To explore the predictive value of magnetic resonance imaging (MRI) with serum lectin-reactive alpha-fetoprotein (AFP-L3) for liver cancer recurrence after percutaneous radiofrequency ablation (RFA).

METHODS

This study included 94 liver cancer patients admitted for RFA treatment and 82 healthy subjects. MRI was performed to record the apparent diffusion coefficient (ADC). The serum concentrations of AFP-L3 were quantified in all participants. The correlation of the AFP-L3 serum level and ADC value with clinical efficacy following RFA was analyzed. Moreover, the prognostic factors affecting liver cancer recurrence were analyzed, as well as the predictive effect of the ADC value and AFP-L3 on liver cancer recurrence.

RESULTS

The serum AFP-L3 level was higher in liver cancer patients than the healthy controls with a lower ADC value. Besides, the patients with tumor residuals had lower ADC values and higher serum AFP-L3 levels than those with complete ablated tumor. The combined detection of the ADC value and serum AFP-L3 level had a sensitivity of 87.50% and a specificity of 87.18% for diagnosing complete ablation after RFA treatment. The number of tumor nodules, tumor diameter, AFP, AFP-L3, and the presence of liver cirrhosis are all independent risk factors for liver cancer recurrence within one year. Meanwhile, the combined detection of the ADC value and serum AFP-L3 level had a good predictive effect on liver cancer recurrence with the sensitivity of 92.86% and a specificity of 69.62%.

CONCLUSION

The ADC values combined with serum AFP-L3 detection had good predictive effects on complete ablation and recurrence of liver cancer after RFA treatment.

摘要

目的

探讨磁共振成像(MRI)联合血清凝集素反应性甲胎蛋白(AFP-L3)对经皮射频消融(RFA)术后肝癌复发的预测价值。

方法

本研究纳入94例接受RFA治疗的肝癌患者和82例健康受试者。进行MRI检查以记录表观扩散系数(ADC)。对所有参与者的血清AFP-L3浓度进行定量分析。分析AFP-L3血清水平和ADC值与RFA术后临床疗效的相关性。此外,分析影响肝癌复发的预后因素,以及ADC值和AFP-L3对肝癌复发的预测作用。

结果

肝癌患者血清AFP-L3水平高于健康对照组,ADC值较低。此外,有肿瘤残留的患者比肿瘤完全消融的患者ADC值更低,血清AFP-L3水平更高。ADC值和血清AFP-L3水平联合检测对RFA治疗后完全消融的诊断敏感性为87.50%,特异性为87.18%。肿瘤结节数量、肿瘤直径、甲胎蛋白、AFP-L3以及肝硬化的存在都是一年内肝癌复发的独立危险因素。同时,ADC值和血清AFP-L3水平联合检测对肝癌复发具有良好的预测作用,敏感性为92.86%,特异性为69.62%。

结论

ADC值联合血清AFP-L3检测对RFA治疗后肝癌的完全消融和复发具有良好的预测作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e52/9325635/f1c224e1af01/ECAM2022-5132135.001.jpg

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