DWI联合SIRI预测肝癌经肝动脉化疗栓塞术后短期疗效的价值
Value of DWI combined with SIRI in predicting the short-term efficacy of transcatheter arterial chemoembolization for hepatocellular carcinoma
郑玉廷 1冯亚园 2栗玉龙 1袁波 1谢峰1
作者信息
- 1. 海军军医大学第三附属医院胆道三科,上海 200438
- 2. 海军军医大学第三附属医院放射诊断科,上海 200438
- 折叠
摘要
目的 探讨磁共振表观扩散系数(Apparent diffusion coefficient,ADC)值联合系统性炎症反应指数(Systemic inflammatory response index,SIRI)预测肝癌经肝动脉化疗栓塞术(Tran-scatheter arterial chemoembolization,TACE)治疗后疗效的价值.方法 选择2019年6月-2022年12月在海军军医大学第三附属医院胆道三科首次行TACE治疗的97例肝癌患者为研究对象.术前1周内对所有患者行MRI检查,记录ADC值、SIRI和临床病理特征.术前收集患者外周血中性粒细胞计数、单核细胞计数、淋巴细胞计数,计算SIRI.术前收集患者的一般资料,包括年龄、性别、病因、Child-Pugh分级、肿瘤最大径、巴塞罗那临床肝癌分期(Barcelona clinical liver cancer staging,BCLC).TACE治疗后1个月,依据美国肝病协会提出的改良实体瘤疗效评价标准对患者术后疗效进行评估,分为客观缓解(Objective remission,OR)组和非OR组.结果 经TACE治疗后,76例患者纳入OR组,21例患者纳入非OR组.与OR组比较,非OR组的肿瘤最大径增大,术前ADC降低,SIRI升高,差异均有统计学意义(P均＜0.05).与肿瘤最大径＜60 mm者相比较,肿瘤最大径≥60 mm者的术前ADC值降低,差异有统计学意义(P＜0.05);与Child-Pugh分级为B级患者比较,A级患者的术前SIRI降低,差异有统计学意义(P＜0.05).Pearson相关性分析结果表明所有患者治疗前ADC值与SIRI呈负相关关系(r=-0.308,P=0.002).ADC值、SIRI及两者联合预测肝癌患者经TACE治疗后疗效的受试者工作特征曲线(Receiver operating characteristic,ROC)下面积分别为 0.854(95％CI:0.766～0.942)、0.857(95％CI:0.772～0.942)和0.925(95％CI:0.868～0.981).结论 磁共振扩散加权成像ADC值联合SI-RI对肝癌经肝动脉化疗栓塞术后短期疗效的预测具有一定价值.
Abstract
Objective To explore the apparent diffusion coefficient(ADC)of magnetic resonance imaging(DWI)combined with systemic inflammatory response index(SIRI).The value of SIRI to predict the cur-ative effect of transcatheter arterial chemoembolization(TACE)after treatment of liver cancer.Methods 97 patients with liver cancer who received TACE treatment for the first time in the hospital from June 2019 to December 2022 were selected as study objects.All patients were examined by MR1 within 1 week before the surgery,ADC values,SIRI and clinicopathological features were recorded.Peripheral blood neutrophil count,monocyte count and lymphocyte count were collected before thesurgery and SIRI was calculated.General data were collected before surgery,including age,sex,etiology,Child-Pugh grade,maximum tumor diameter and Barcelona clinical liver cancer staging(BCLC).1 month after TACE treatment,the postoperative efficacy of the patients were evaluated,and the patients were divided into objective remission(OR)and non-OR remission,according to the evaluation criteria of improved solid tumor efficacy pro-posed by the American Liver Association.Results After TACE treatment,76 patients were included in the OR group and 21 patients were included in the non-OR group.Compared with OR group,the maxi-mum tumor diameter in the non-OR group was significantly increased,preoperative ADC was significantly decreased,and SIRI was significantly increased,with statistical significance(all P＜0.05).Compared with the patients with maximum tumor diameter＜60 mm,preoperative ADC values in patients with max-imum tumor diameter ≥60 mm were significantly decreased,and the difference was statistically significant(P＜0.05).Compared with patients with Child-Pugh grade B,preoperative SIRI in patients with grade A was significantly reduced(P＜0.05).Pearson correlation analysis showed that ADC values were signifi-cantly negatively correlated with SIRI before the treatment in all patients(r=-0.308,P=0.002).The area under the subject work characteristic curve of ADC value,SIRI and their combination to predict the efficacy of TACE in patients with liver cancer were 0.854(95％CI:0.766～0.942),0.857(95％CI:0.772～0.942)and 0.925(95％CI:0.868～0.981).Conclusion MRI diffusion weighted imaging ADC value combined with SIRI has a certain value in predicting the short-term efficacy of transcatheter arterial chemoembolization for hepatoma.
关键词
肝肿瘤/经导管肝动脉栓塞术/表观扩散系数/系统性炎症反应指数/疗效Key words
liver tumor/transcatheter arterial chemoembolization(TACE)/apparent diffusion coefficient/systemic inflammatory response index(SIRI)/curative effect引用本文复制引用
基金项目
上海市研究型医师创新项目转化专项(SHDC2022CRD047)
出版年
2024
NETL
NSTL
万方数据