摘要
目的探讨血清学指标联合超声造影时间-强度曲线对肝脏肿瘤良恶性的鉴别诊断价值。方法选取2016年4月至2017年10月新疆维吾尔自治区人民医院收治的肝脏占位性病变患者176例作为研究对象,按照病理组织检查结果将其分为恶性组(65例)和良性组(111例),检测2组血清学指标,包括甲胎蛋白、癌胚抗原以及糖类抗原125。观察比较2组患者超声造影时间-强度曲线参数。采用受试者工作特征(ROC)曲线分析血清学指标联合时间-强度曲线对肝脏良恶性肿瘤的鉴别诊断价值。结果恶性组患者血清甲胎蛋白、癌胚抗原以及糖类抗原125水平均明显高于良性组[(23±6)μg/L比(14±3)μg/L、(18±4)μg/L比(15±3)μg/L、(38±7) k U/L比(22±5) k U/L](均P <0. 05)。恶性组患者峰值时间明显短于良性组[(31±8) s比(44±10) s],峰值强度、增强速率、消退速率均明显大于良性组[(72±6) d B比(58±4) d B、(2. 1±0. 6) d B/s比(1. 1±0. 3) d B/s、(0. 134±0. 040) d B/s比(0. 083±0. 021) d B/s](均P <0. 05)。甲胎蛋白、癌胚抗原、糖类抗原125、达峰时间、峰值强度诊断肝脏恶性肿瘤ROC曲线下面积分别为0. 771、0. 623、0. 765、0. 701、0. 844,各指标联合诊断曲线下面积为0. 903。结论血清学指标与超声造影时间-强度曲线对肝脏良恶性肿瘤鉴别诊断均有一定价值,二者联合运用可有效提高对肝脏恶性肿瘤的鉴别诊断价值。
Objective To explore the value of serological indicators combined with contrast-enhanced ultrasound time-intensity curve in the differential diagnosis of benign and malignant liver tumors. Methods Totally176 patients with focal liver lesions were included in People’s Hospital of Xinjiang Uygur Autonomous Region from April 2016 to October 2017. According to the pathological results,the patients were divided into malignant group( 65 cases) and benign group( 111 cases). Serum levels of alpha-fetoprotein( AFP),carcinoembryonic antigen( CEA) and carbohydrate antigen 125( CA125) were detected. Parameters of contrast-enhanced ultrasound time-intensity curve were measured. Diagnostic values of serological indicators and ultrasound parameters were analyzed by receiver operating characteristic( ROC) curve. Results Serum levels of AFP,CEA and CA125 in malignant group were significantly higher than those in benign group[( 23 ± 6)μg/L vs( 14 ± 3)μg/L,( 18 ±4)μg/L vs( 15 ± 3)μg/L,( 38 ± 7) k U/L vs( 22 ± 5) k U/L]( all P < 0. 05). Peak time in malignant group was significantly shorter than that in benign group[( 31 ± 8) s vs( 44 ± 10) s];peak intensity,enhancement rate and regression rate in malignant group were significantly higher than those in benign group[( 72 ± 6) d B vs( 58 ± 4) d B,( 2. 1 ± 0. 6) d B/s vs( 1. 1 ± 0. 3) d B/s,( 0. 134 ± 0. 040) d B/s vs( 0. 083 ± 0. 021) d B/s]( all P < 0. 05). Area under ROC curve of AFP,CEA,CA125,peak time and peak intensity in diagnosing malignant liver tumor were0. 771,0. 623,0. 765,0. 701 and 0. 844,respectively;the area under curve of joint diagnosis was 0. 903.Conclusions Serological indicators and contrast-enhanced ultrasound time-intensity curve show certain values for the differential diagnosis of benign and malignant liver tumors. Combined diagnosis can significantly improve the diagnostic value for malignacy.
作者
齐宝文
吕娟
张利
Qi Baowen;Lyu Juan;Zhang Li(Department of Ultrasound,People's Hospital of Xinjiang Uygur Autonomous Region ,Urumqi 830001,China)
出处
《中国医药》
2019年第10期1527-1530,共4页
China Medicine
基金
新疆维吾尔自治区自然科学基金(2017D01C120)~~
关键词
肝脏肿瘤
血清学
超声造影
时间-强度曲线
良恶性
鉴别诊断
Liver neoplasms
Serology
Contrast-enhanced ultrasound
Time-intensity curve
Benign and malignant
Differential diagnosis
作者简介
通信作者:张利,Email:zhenhaiping995@163.com.
