MRI扫描联合血清4项肿瘤标志物诊断原发性肝癌的临床价值研究

目的:探究磁共振成像(MRI)扫描联合血清4项肿瘤标志物诊断原发性肝癌(PHC)的临床价值。方法:将我院从2017年9月~2019年8月收治的65例PHC患者(肝癌组)纳入研究,另选取同期我院收治的60例良性肝病患者作为对照组。比较两组MRI图像特征。此外,检测并比较两组血清甲胎蛋白(AFP)和甲胎蛋白异质体(AFP-L3)、高尔基体蛋白73(GP73)、磷脂酰肌醇蛋白聚糖-3(GPC-3)水平。以病理诊断为金标准,分析不同诊断方式应用于PHC患者诊断中的效能。结果:PHC患者的MRI图像表现为边界清晰,呈类圆形或不规则分叶状,肝癌组T1WI呈低或稍低信号人数占比高于对照组,且T2WI、DWI呈高信号强度人数占比高于对照组(均P<0.05)。肝癌组血清AFP、AFP-L3、GP73、GPC-3水平均高于对照组(均P<0.05)。以病理诊断为金标准,MRI联合血清AFP、AFP-L3、GP73、GPC-3诊断PHC的灵敏度、特异度以及准确度分别为95.24%(40/42)、95.65%(22/23)、95.38%(62/65),均高于MRI诊断的73.81%(31/42)、69.57%(16/23)、72.31%(47/65)(P<0.05),以及血清4项肿瘤标志物联合诊断的80.95%(34/42)、73.91%(17/23)、78.46%(51/65)(P<0.05)。结论:PHC患者血清AFP、AFP-L3、GP73、GPC-3水平升高,MRI扫描联合血清AFP、AFP-L3、GP73、GPC-3检测可作为诊断PHC的有效手段。

The Clinical Value of MRI Scanning Combined with 4 Items Tumor Markers in the Diagnosis of Primary Liver Cancer

Objective: To investigate and analyze the clinical value of magnetic resonance imaging(MRI) scanning combined with4 items tumor markers in the diagnosis of primary liver cancer(PHC). Methods: 65 patients with PHC(liver cancer group) treated in our hospital from September 2017 to August 2019 were included in the study. Another 60 cases of benign liver disease were selected as the control group in our hospital at the same time. MRI features of the two groups were compared. In addition, serum alpha fetoprotein(AFP) and alpha-fetoprotein isoplast(AFP-L3), Golgi protein 73(GP73) and phosphatidylinosano-3(GPC-3) levels were detected and compared between the two groups. With pathological diagnosis as the gold standard, the effectiveness of different diagnostic methods in patients with PHC was analyzed. Results: MRI images of patients with PHC showed clear boundaries, similar to round or irregular lobules. The proportion of patients in the liver cancer group with low or slightly low T1 WI signal intensity and equal signal intensity were higher than those in the control group, and the proportion of patients with high T2 WI and DWI signal intensity were higher than those in the control group(all P<0.05). Pathological diagnosis was the gold standard, the sensitivity, specificity and accuracy of MRI combined with serum AFP, AFP-L3, GP73 and GPC-3 in PHC diagnosis were 95.24%(40/42), 95.65%(22/23) and 95.38%(62/65) respectively,were higher than 73.81%(31/42), 69.57%(16/23), 72.31%(47/65) in MRI diagnosis(P<0.05), and 80.95%(34/42), 73.91%(17/23),78.46%(51/65) in combined diagnosis of four serum tumor markers(P<0.05). Conclusion: The levels of serum AFP, AFP-L3, GP73 and GPC-3 in PHC patients were increased, MRI scan combined with serum AFP, AFP-L3, GP73, GPC-3 can be used as effective means to diagnose PHC.