MRI联合血清ApoB、γ-GT用于原发性肝癌临床价值探讨

目的探讨磁共振成像(MRI)联合血清载脂蛋白B(ApoB)、γ-谷氨酰转肽酶(γ-GT)水平检测在原发性肝癌(PHC)中的临床价值。方法选取2018年1月至2019年3月住院治疗的PHC患者(43例)和良性肝病患者(58例),均行MRI检查,并采集肘部外周血,检测血清ApoB、γ-GT水平,以病理学诊断为"金标准",分析MRI联合血清ApoB和γ-GT在PHC中的临床应用价值。结果与良性肝病组比较,PHC组病灶处转运常数K^trans值、速率常数K_ep和血管外细胞外间隙体积百分比(V_e)升高(P<0.05);与良性肝病组比较,PHC组血清ApoB水平降低,γ-GT水平升高(P<0.05);动态增强扫描MRI灌注参数K^trans(≥0.32min^-1)、K_ep(≥1.21min^-1)、V_e值(≥0.39%)和血清ApoB(≤0.98g/L)、γ-GT(≥60.94U/L)联合检测AUC为0.860(95%CI为0.778~0.943),分别高于单一检测AUC(P<0.05);以病理学诊断为"金标准",MRI、血清ApoB和γ-GT及联合检测符合率分别为78.22%、65.35%、72.28%和79.21%,与单一检测比较,联合检测符合率、灵敏度均有提高。结论MRI联合血清ApoB、γ-GT对PHC诊断价值高于单一检测,可为PHC临床诊断提供重要的参考价值。

Clinical Value of MRI Combined with Serum ApoB andγ-GT in Primary Hepatic Carcinoma

Objective To explore the clinical value of magnetic resonance imaging(MRI)combined with serum apolipoprotein B(ApoB)andγ-glutamyl transpeptidase(γ-GT)detection in primary hepatic carcinoma(PHC).Methods A total of 43 PHC patients and 58 patients with benign hepatic diseases who were admitted to the hospital from January 2018 to March 2019 were enrolled.All underwent MRI examination.Peripheral blood was collected from the elbow to detect the levels of serum ApoB andγ-GT.Taking pathological diagnosis as the golden standard,the clinical application value of MRI combined with serum ApoB andγ-GT in PHC was analyzed.Results Compared with the benign hepatic disease group,transfer constant(K^trans),rate constant(K_ep),and extravascular extracellular space volume fraction(V_e)were increased(P<0.05),level of serum ApoB was decreased,and the level ofγ-GT was increased in PHC group(P<0.05).AUC of combined detection with dynamic contrast enhancement MRI perfusion parameters(K^trans not lower than 0.32/min^-1,K_ep not lower than 1.21/min^-1,V_e not lower than 0.39%),serum ApoB not higher than 0.98g/L andγ-GT not lower than 60.94 U/L was 0.860(95%CI 0.778-0.943),which was higher than that of the single index(P<0.05).Considering pathological diagnosis as the golden standard,coincidence rates of MRI,serum ApoB,γ-GT,and combined detection were 78.22%,65.35%,72.28%,and 79.21%,respectively.Compared with single detection,the coincidence rate and sensitivity of combined detection were increased.Conclusion The diagnostic value of MRI combined with serum ApoB andγ-GT is higher than that of the single index for PHC,which can provide an important reference for the clinical diagnosis of PHC.