Application of Clinical Features Combined with MRI in the Differential Diagnosis of Alpha-fetoprotein Negative Hepatocellular Carcinoma and Focal Nodular Hyperplasia and Model Establishment
Objective To investigate the differences of clinical features and magnetic resonance imaging(MRI)between alpha-fetoprotein(AFP)negative hepatocellular carcinoma(HCC)and focal nodular hyperplasia(FNH),,establish a Logistic regression diagnostic model and verify the model.Methods Clinical and MRI data of 72 AFP negative HCC patients(HCC group)and 72 FNH patients(FNH group)in our hospital from August 2020 to August 2022 were retrospectively analyzed.The difference of clinical and MRI features between the two groups was analyzed,and the risk factors were screened by multivariate Logistic regression analysis,and the regression equation was established to establish the prediction model.In addition,70 patients who came to our hospital from September 2022 to May 2023 were selected as the validation group(32 patients with HCC and 48 patients with FNH),and verified by receiver operating characteristics(ROC).Results The age and hepatitis B history ratio in HCC group were higher than those in FNH group(P＜0.05).The proportion of capsule,lesion containing fat,lesion necrosis or cystic change,fast in and fast out enhancement and lesion bleeding were higher in HCC group was higher than that in FNH group,and the proportion of central scar and delayed imaging was lower than that in FNH group(P＜0.05).Logistic regression analysis showed that age,history of hepatitis B,capsule,no central scar,lesions containing fat,lesion necrosis or cystic change,fast in and fast out mode of enhancement and non-delayed imaging were all independent risk factors for HCC(P＜0.05).After Logistic regression analysis,the diagnostic model was established:logit(p)=age ×1.287+history of hepatitis B ×1.469+enveloped ×1.535+central scar ×(-0.954)+focal fat content ×1.194+focal necrosis or cystic change ×1.233+enhancement pattern ×(-1.169)+delayed imaging×(-0.852);Internal validation:diagnostic AUC was 0.975,95％CI was 0.944-0.992,external validation:model AUC was 0.871,95％CI was 0.818-0.914,x2 was 15.398 patients.Conclusion AFP negative HCC has differences in age,history of hepatitis B,MRI imaging presence or absence of capsule,central scar,focal fat content,enhancement patterns and delayed imaging.Logistic regression analysis showed that the above clinical features and MRI imaging findings were independent risk factors for AFP negative HCC.Moreover,the established diagnostic model has better diagnostic efficacy for AFP negative HCC.
Alpha-fetoproteinNegativeHepatocellular CarcinomaFocal Nodular Hyperplasia Of LiverClinical FeaturesMagnetic Resonance Imaging
万方数据
维普
