MRI参数联合血清CHI3L1、SEMA-3B在肝细胞肝癌早期诊断中的价值
The value of MRI parameters combined with serum CHI3L1 and SEMA-3B in early diagnosis of hepatocellular carcinoma
李秋实 1徐珂 1杨洁1
作者信息
- 1. 河南大学第一附属医院医学影像科,开封 475000
- 折叠
摘要
目的 研究分析磁共振成像(MRI)参数联合血清几丁质酶-3样蛋白1(CHI3L1)、信号素3B(SEMA-3B)在肝细胞肝癌(HCC)早期诊断中的价值.方法 选取2022年7月-2024年7月本院收治的82例HCC患者为肝癌组,另选同期治疗的肝良性肿瘤患者86例为良性组,体检的健康志愿者98例为对照组,ELISA检测血清CHI3L1、SEMA-3B水平,收集分析一般临床资料,绘制受试者工作特征(ROC)曲线分析MRI参数联合血清CHI3L1、SEMA-3B对HCC的诊断价值,Kappa检验评估联合与病理结果的一致性.结果 与对照组相比,良性组及肝癌组血清CHI3L1水平,MRI参数[肝动脉灌注指数(HPI)、容积转移常数(Ktrans)]显著升高,SEMA-3B水平显著降低(P＜0.05),且肝癌组血清CHI3L1水平,MRI参数(HPI、Ktrans)较良性组显著升高,SEMA-3B水平较良性组显著降低(P＜0.05);肝癌患者的血清CHI3L1、SEMA-3B及MRI参数(HPI、Ktrans)在不同的肿瘤直径、肿瘤数目、分化程度及是否发生转移之间比较差异具有统计学意义(P＜0.05);CHI3L1、SEMA-3B、MRI参数(HPI、Ktrans)以及联合诊断 HCC 的 AUC 分别为 0.821、0.839、0.804、0.824、0.966,联合诊断的 AUC 显著优于 CHI3L1(Z=4.738,P＜0.001)、SEMA-3B(Z=4.326,P＜0.001)、HPI(Z=4.746,P＜0.001)、Ktrans(Z=4.755,P＜0.001)单独诊断,与病理检测结果相比,联合检测误诊12例,漏诊2例,联合与病理检测的Kappa值为0.834(P＜0.05).结论 在HCC患者中,MRI参数、血清CHI3L1水平升高,SEMA-3B水平降低,MRI参数联合血清CHI3L1、SEMA-3B在HCC早期诊断中具有良好的辅助诊断价值.
Abstract
Objective To investigate and analyze the value of magnetic resonance imaging(MRI)parameters combined with serum chitinase-3-like protein 1(CHI3L1)and semaphorin 3B(SEMA-3B)in the early diagnosis of hepatocellular carcinoma(HCC).Methods From July 2022 to July 2024,82 HCC patients admitted to our hospital were included as the liver cancer group,86 benign liver tumor patients were selected as the benign group,and 98 healthy volunteers who underwent physical examination were selected as the control group.ELISA was applied to detect serum levels of CHI3L1 and SEMA-3B.General clinical data were collected and analyzed.Receiver operating characteristic(ROC)curves were plotted to analyze the diagnostic value of MRI parameters combined with serum CHI3L1 and SEMA-3B for HCC.Kappa test was applied to evaluate the consistency between the combined detection and pathological results.Results Compared with the control group,the serum CHI3L1 level and MRI parameters[hepatic artery perfusion index(HPI),volume transfer constant(Ktrans)]were greatly higher in the benign group and liver cancer group,while the SEMA-3B level was greatly lower(P＜0.05).The serum CHI3 L1 level and MRI parameters(HPI,Ktrans)in the liver cancer group were great-ly higher than those in the benign group,and the SEMA-3 B level was greatly lower than that in the benign group(P＜0.05).The ser-um CHI3L1,SEMA-3B,and MRI parameters(HPI,Ktrans)of liver cancer patients showed statistically great differences among dif-ferent tumor diameters,tumor numbers,differentiation degrees,and whether metastasis occurred(P＜0.05).The AUC of CHI3L1,SEMA-3 B,MRI parameters(HPI,Ktrans),and combined diagnosis of HCC was 0.821,0.839,0.804,0.824,and 0.966,respec-tively.The AUC of combined diagnosis was greatly better than that of CHI3L1(Z=4.738,P＜0.001),SEMA-3B(Z=4.326,P＜0.001),HPI(Z=4.746,P＜0.001),and Ktrans(Z=4.755,P＜0.001)diagnosed separately.Compared with pathological test results,there were 12 cases of misdiagnosis and 2 cases of missed diagnosis in combined detection,the Kappa value of combined detec-tion with pathological detection was 0.834(P＜0.05).Conclusion In HCC patients,MRI parameters and serum CHI3L1 level are elevated,while SEMA-3B level is reduced.The combination of MRI parameters and serum CHI3L1 and SEMA-3B has good auxiliary diagnostic value in the early diagnosis of HCC.
关键词
磁共振成像/几丁质酶-3样蛋白1/信号素3B/肝细胞肝癌/诊断Key words
magnetic resonance imaging/chitinase-3-like protein 1/semaphorin 3 B/hepatocellular carcinoma/diagnosis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据