Study on the predictive efficacy of preoperative MR-DWI combined with serum alpha-fetoprotein for microvascular invasion in patients with hepatocellular carcinoma
10.3969/j.issn.1672-8270.2024.09.011
- VernacularTitle:术前磁共振弥散加权成像联合血清甲胎蛋白对肝细胞癌患者微血管侵犯的预测效能研究
- Author:
Xiaodong LIN
1
;
Hua YANG
;
Li HE
Author Information
1. 张家港市中医医院放射科 张家港 215600
- Keywords:
Hepatocellular carcinoma(HCC);
Microvascular invasion(MVI);
Apparent diffusion coefficient ADC);
Exponential apparent diffusion coefficient(eADC);
Alpha-fetoprotein(AFP);
Prediction
- From:
China Medical Equipment
2024;21(9):53-59
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive efficacy of apparent diffusion coefficient(ADC),exponential ADC(eADC)of preoperative magnetic resonance diffusion-weighted imaging(MR-DWI)combined with serum alpha fetoprotein(AFP)for microvascular invasion(MVI)in patients with hepatocellular carcinoma(HCC).Methods:A prospective study was conducted on 133 HCC patients who underwent liver cancer resection at Zhangjiagang Hospital of Traditional Chinese Medicine from January 2017 to February 2023.Based on whether occurred MVI in postoperative pathological diagnosis,they were divided into positive MVI group(62 cases)and negative MVI group(71 cases).The preoperative ADC values,ADC ratio(T/L),ratio of eADC value to eADC value(eT/L),serum AFP and other clinical pathological data were compared between the two groups.Multivariate logistic regression was used to analyze the risk factors of MVI in HCC patients.The receiver operating characteristic(ROC)curve and area under curve(AUC)were applied to assess the predictive efficacies of each indicator and the combined detection of all indicator for MVI.Results:The ADC value and T/L value of ADC in the positive MVI group were lower than those in the negative MVI group,while the eT/L value of eADC was higher than that in the negative MVI group,and the differences were statistically significant(t=3.972,5.297,3.521,P<0.05),respectively.There was no statistically significant difference in eADC values between the positive MVI group and the negative MVI group(P>0.05).The serum AFP level in the positive MVI group was higher than that in the negative MVI group,and the difference was statistically significant(U=3.615,P<0.05).The tumor diameter,alanine aminotransferase(ALT)and total bilirubin(TBil)level in the positive MVI group were higher than those in the negative MVI group,and the differences were statistically significant(t=7.686,2.083,2.923,P<0.05),respectively.The proportions of patients with multiple lesions,clinical stage Ⅲ,low differentiation and incomplete capsule in the positive MVI group were higher than those in the negative MVI group,and the differences were statistically significant(x2=6.656,4.600,9.030,5.328,P<0.05),respectively.Multivariate logistic regression analysis showed that tumor diameter>5 cm,incomplete capsule,elevated AFP,decreased T/L value of ADC,the increased eT/L value in eADC were the risk factors for MVI in HCC patients(OR=1.382,1.423,1.043,0.815,1.146,P<0.05),respectively.ROC curve analysis showed that the AUC(95％CI)values of T/L value of ADC,eT/L value of eADC and AFP were respectively 0.721(0.442-0.988),0.748(0.525-0.948)and 0.720(0.460-0.985)in predicting MVI in HCC patients.The AUC(95％CI)value of the combined prediction of them was 0.860(0.731-0.974),which was higher than the predictive efficacy of single indicator.Conclusion:The decrease in T/L value of ADC in preoperative DWI,the increases of eT/L value of eADC and serum AFP are risk factors for MVI in HCC patients.The combination of preoperative T/L value of ADC,eT/L value of eADC and serum AFP has higher predictive efficacy for MVI in HCC patients.
