超声造影联合血清AFP、GGT与GLR对肝细胞癌微血管侵犯的预测价值.

Objective: To analyze the predictive value of contrast-enhanced ultrasound (CEUS) combined with serum alpha-fetoprotein (AFP), γ-glutamyl transpeptidase (GGT) and lymphocyte count ratio (GLR) for microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods: 177 HCC patients who underwent hepatectomy in The 73rd Group Army Hospital of the Chinese People's Liberation Army from October 2018 to October 2023 were selected, all patients underwent CEUS and serum AFP, GGT and GLR examinations 1 week before operation. According to the results of postoperative pathological examination of MVI, patients were divided into MVI positive group (n=52) and MVI negative group (n=125). The risk factors affecting MVI in HCC patients were analyzed by multivariate Logistic regression analysis, the predictive value of CEUS combine with AFP, GGT and GLR for MVI in HCC patients were analyzed by receiver operating characteristic (ROC) curve. Results: The onset time, peak time and clearance time in MVI positive group were shorter than those in MVI negative group (P<0.05). AFP, GGT and GLR in MVI positive group were significantly higher than those in MVI negative group(P<0.05). Multivariate Logistic regression analysis showed that elevated AFP, elevated GGT, elevated GLR, irregular lesion morphology, shortened onset time, shortened peak time, and shortened clearance time were independent risk factors for MVI in HCC patients (P<0.001). The ROC results showed that, the area under the curve of MVI in HCC patients predicted by the combination of serum AFP, GGT and GLR was 0.901, which was significantly larger than that of single detection(P<0.05). Conclusion: The levels of serum AFP, GGT and GLR in patients with MVI after HCC operation increased, and the time of initial increase, peak time and clearance time were shortened, which were independent risk factors for MVI in HCC patients. CEUS combined with AFP, GGT and GLR has a high predictive value for MVI in HCC patients. [ABSTRACT FROM AUTHOR]