Abstract:

Study on the value of des-γ-carboxy-prothrombin combined with enhanced CT in predicting microvascular invasion of hepatocellular carcinoma        HE Tao，GUO Xiao-dong，YU Kuai，et al. Department of Hepatobiliary Surgery & Sichuan Provincial Academician (Expert) Workstation，the Affiliated Hospital of Southwest Medical University，Luzhou 646000，China
Corresponding author：FU Wen-guang，E-mail：fuwg@outlook.com
Abstract    Objective    To explore the predictive value of preoperative enhanced CT combined with des-γ-carboxy-prothrombin (DCP) level for microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods    The clinical data of 105 cases of HCC diagnosed by pathology after surgical resection from January 1，2016 to March 1，2019 in the the Affiliated Hospital of Southwest Medical University were analyzed retrospectively. According to the pathological results，they were divided into two groups: experimental group (with MVI): 30 cases，control group（without MVI）: 75 cases，using univariate and multivariate logistic regression analysis to predict influencing factors of MVI in HCC. The receiver working curve（ROC curve）was used to evaluate the predictive value of DCP combined with enhanced CT for MVI in HCC. Results    Univariate analysis showed that serum DCP level (t=4.667，P<0.001)，tumor size (t=9.427，P<0.001)，capsule type (χ2=18.456，P<0.001) and pathological type (χ2=11.914，P=0.003) were risk factors for MVI in HCC，with statistically significant differences (P<0.05). Multivariate logistic regression analysis showed that tumor size（OR=12.610，P=0.001），capsule type (OR=14.363，P=0.008) and serum DCP level （OR=19.254，P=0.014）were independent risk factors of MVI in HCC，with statistically significant differences (P<0.05). ROC curve analysis showed that the sensitivity，specificity and area under the curve (AUC) of serum DCP and enhanced CT model for predicting MVI in HCC were 90.0%，74.7% and 0.856，respectively. Conclusion    Preoperative serum DCP level combined with enhanced CT helps predict MVI in HCC.

Key words: hepatocellular carcinoma；microvascular invasion；des-&gamma, -carboxy-prothrombin(DCP)；enhanced computed tomography

摘要：

目的    探讨术前异常凝血酶原（DCP）联合增强CT对肝细胞癌（HCC）微血管侵犯（MVI）的预测价值。方法    回顾性分析2016-01-01至2019-03-01西南医科大学附属医院收治的行手术切除的105例HCC病人的临床资料。根据病理学检查分为MVI组（30例）和无MVI组（75例），分析HCC发生MVI的影响因素，采用受试者工作曲线（ROC）评估DCP联合增强CT预测HCC发生MVI的价值。结果    单因素分析显示，血清DCP水平（t=4.667，P<0.001）、肿瘤大小（t=9.427，P<0.001）、包膜类型（χ2=18.456，P<0.001）和病理类型（χ2=11.914，P=0.003）是影响HCC发生MVI的危险因素（P<0.05）。多因素分析显示，肿瘤大小（OR=12.610，P=0.001）、包膜类型（OR=14.363，P=0.008）、血清DCP水平（OR=19.254，P=0.014）是影响HCC发生MVI的独立危险因素（P<0.05）。ROC分析结果显示，血清DCP联合增强CT预测HCC发生MVI的敏感度、特异度及曲线下面积（AUC）分别为90%、74.7%和0.856。结论    术前DCP水平检测联合增强CT检查有助于预测HCC是否存在MVI。

关键词: 肝细胞癌, 微血管侵犯, 异常凝血酶原, 增强CT