超声造影结合血清甲胎蛋白、磷脂酰肌醇蛋白聚糖3对早期肝硬化结节状小肝癌的诊断价值研究

目的：探讨超声造影(CEUS)结合血清甲胎蛋白(AFP)、磷脂酰肌醇蛋白聚糖3(GPC3)对早期肝硬化结节状小肝癌的诊断价值研究。方法：回顾性分析本院收治的78例早期发现肝硬化合并小结节样病灶患者的临床资料,根据病理结果分为小肝癌组(46例)和良性病变组(32例)。所有患者术前均行超声造影、血清AFP、GPC3水平检测,并比较两组之间各参数的差异,分析三者单独或联合诊断小肝癌的价值。结果：小肝癌组的超声造影特征与良性病变组显著不同(P<0.05),小肝癌组大多呈“快进快出”表现,而良性病变组大多呈“慢进慢出”表现。小肝癌组患者血清AFP、GPC3水平显著高于良性病变组(P<0.05)。超声造影结合血清AFP、GPC3水平联合诊断HCC的准确性、敏感度、特异度、阳性预测值、阴性预测值最高(P<0.05)。结论：超声造影结合血清AFP、GPC3有助于提高对早期肝硬化结节状小肝癌的鉴别诊断价值,对临床治疗方案的选择有一定指导意义。

The value of contrast-enhanced ultrasound combined with serum AFP and GPC3 in the diagnosis of small nodular liver cancer in early cirrhosis

Objective: To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with serum alpha-fetoprotein (AFP) and glypican 3 (GPC3) for early liver cirrhosis and nodular small liver cancer. Methods:The clinical data of 78 patients with early detection of liver cirrhosis and small nodular lesions were retrospectively analyzed. According to the pathological results, they were divided into small liver cancer group (46 cases) and benign lesion group (32 cases). All patients underwent contrast-enhanced ultrasound, serum AFP, and GPC3 levels before operation. The differences in parameters between the two groups were compared, and the value of the three alone or in combination in the diagnosis of small liver cancer was analyzed.Results: The contrast-enhanced ultrasound characteristics of the small liver cancer group were significantly different from those of the benign lesion group (P<0.05). Most of the small liver cancer group showed "fast in and out" performance, while the benign lesion group showed "slow in and slow out" performance. The levels of serum AFP and GPC3 in the small liver cancer group were significantly higher than those in the benign lesion group (P<0.05). Contrast-enhanced ultrasound combined with serum AFP and GPC3 levels in the diagnosis of HCC had the highest accuracy, sensitivity, specificity, positive predictive value, and negative predictive value (P<0.05). Conclusion: Contrast-enhanced ultrasound combined with serum AFP and GPC3 can help improve the differential diagnosis value of small nodular liver cancer in early cirrhosis, and has certain guiding significance for the selection of clinical treatment options.