摘要
目的探究体素内不相干运动扩散加权成像(IVIM-DWI)参数联合血清热休克蛋白70(HSP70)、缺氧诱导因子-1α(HIF-1α)水平检测在肝细胞癌(HCC)经动脉化疗栓塞(TACE)治疗预后的预测价值。方法选取83例HCC患者,比较不同预后患者一般资料、IVIM-DWI参数[表现扩散系数(ADC)、灌注系数f(f)、伪扩散系数D^(*)(D^(*))、纯扩散系数D(D)]及血清HSP70、HIF-1α水平。采用Logistic分析预后的影响因素,采用ROC曲线分析预测价值。结果两组门脉癌栓比较,差异有统计学意义(P<0.05);预后良好组ADC、D高于预后不良组,D^(*)、f、血清HIF-1α水平、HSP70水平均低于预后不良组(P<0.05)。门脉癌栓、ADC、D、D^(*)、f、血清HSP70、HIF-1α水平为预后不良的危险因素(P<0.05)。IVIM-DWI参数联合血清HSP70、HIF-1α水平检测的AUC为0.874,最佳预测灵敏度为96.30%、特异度为78.57%。结论IVIM-DWI参数、血清HSP70、HIF-1α水平联合检测可显著提高HCC患者TACE治疗预后的预测价值。
Objective To investigate the predictive value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)parameters,combined with serum levels of heat shock protein 70(HSP70)and hypoxia inducible factor-1α(HIF-1α),in predicting the prognosis of hepatocellular carcinoma(HCC)patients treated with transarterial chemoembolization(TACE).Methods 83 HCC patients were selected.Their general information,IVIMDWI parameters including apparent diffusion coefficient(ADC),perfusion fraction(f),pseudo-diffusion coefficient(D^(*)),and pure diffusion coefficient(D),as well as serum levels of HSP70 and HIF-1α,were compared between patients with different prognoses.Logistic regression analysis was used to identify prognostic factors,and receiver operating characteristic(ROC)curve analysis was conducted to assess predictive value.Results There was a statistically significant difference in the presence of portal vein cancer thrombus between the two prognosis groups(P<0.05).The ADC and D values were higher in the good prognosis group compared to the poor prognosis group,while the D,f values,and serum levels of HIF-1αand HSP70 were lower(P<0.05).Portal vein cancer thrombus,ADC,D,D^(*),f,and the levels of serum HSP70 and HIF-1αwere identified as risk factors for poor prognosis(P<0.05).The area under the ROC curve(AUC)for the combination of IVIM-DWI parameters,serum HSP70,and HIF-1αlevels was 0.874,with an optimal predictive sensitivity of 96.30%and specificity of 78.57%.Conclusion The combined detection of IVIM-DWI parameters,serum HSP70,and HIF-1αlevels can significantly improve the predictive value for the prognosis of HCC patients treated with TACE.
作者
韩树亮
杨洁
郭孟珂
徐珂
HAN Shuliang;YANG Jie;GUO Mengke;XU Ke(Department of Medical Imaging,the First Affiliated Hospital of Henan University,Kaifeng 475000,China)
出处
《华夏医学》
2025年第2期55-60,共6页
Acta Medicinae Sinica
基金
2022年度开封市科技发展计划项目(2203032)。
关键词
体素内不相干运动扩散加权成像参数
热休克蛋白70
缺氧诱导因子-1α
肝细胞癌
经肝动脉化疗栓塞术
intravoxel incoherent motion diffusion-weighted imaging parameters
heat shock protein 70
hypoxia inducible factor-1α
hepatocellular carcinoma
transcatheter arteri chemoembolization
