标题：超声造影参数与原发性肝癌患者消融疗效和近期预后的相关性

      作者：陈姗姗，闫静茹，何宁    西安国际医学中心医院超声诊疗中心，陕西 西安 710100

      卷次： 2023年34卷18期

      【摘要】 目的 探究超声造影(CEUS)参数与原发性肝癌(PLC)患者消融疗效和近期预后的关系。方法 选取2019年10月至2021年5月在西安国际医学中心医院行超声引导下射频消融术治疗的110例PLC患者开展前瞻性研究。治疗结束后1个月行CEUS检查以评估疗效，比较不同疗效患者CEUS定量参数[达峰时间(TTP)、峰值强度(PI)、增强速率(ER)]，采用Spearman相关系数分析CEUS定量参数与PLC患者消融疗效、近期预后的相关性，采用受试者工作特征(ROC)曲线、决策曲线(DCA)分析TTP、PI、ER预测近期预后的价值和临床效用。结果 超声引导下射频消融术治疗PLC缓解率为85.45%；完全缓解患者TTP长于部分缓解患者、稳定和进展患者，PI、ER低于部分缓解患者、稳定和进展患者，差异均有统计学意义(P<0.05)；经Spearman相关系数分析结果显示，PLC患者消融疗效与TTP呈正相关(r=0.723，P<0.05)，与PI、ER呈负相关(r=-0.765、-0.843，P<0.05)；PLC患者近期预后与TTP呈正相关(r=0.723，P<0.05)，与PI、ER呈负相关(r=-0.765、-0.843，P<0.05)；经ROC分析结棍显示，TTP、PI、ER联合预测近期预后为死亡的曲线下面积(AUC)为0.937；采用DCA分析结果显示TTP、PI、ER联合在预测PLC患者消融治疗近期预后方面拥有良好的临床效用。结论 CEUS定量参数TTP、PI、ER与PLC患者消融疗效、近期预后密切相关，TTP、PI、ER联合可为临床预测近期预后提供可靠参考依据。
      【关键词】 原发性肝癌；超声引导下射频消融术；超声造影；疗效；预后
      【中图分类号】 R735.7 【文献标识码】 A 【文章编号】 1003—6350（2023）18—2711—05

Correlation between contrast-enhanced ultrasound parameters and ablation efficacy and short-term prognosisin patients with primary liver cancer.
CHEN Shan-shan, YAN Jing-ru, HE Ning. Ultrasonic Diagnosis and TreatmentCenter, Xi'an International Medical Center Hospital, Xi'an 710100, Shaanxi, CHINA
【Abstract】 Objective To investigate the relationship between contrast-enhanced ultrasound (CEUS) parame-ters and ablation efficacy and short-term prognosis in patients with primary liver cancer (PLC). Methods A prospec-tive study was conducted on 110 PLC patients who underwent ultrasound-guided radiofrequency ablation at Xi'an In-ternational Medical Center Hospital from October 2019 to May 2021. CEUS examinations were performed one monthafter the end of treatment to evaluate the efficacy, and the quantitative parameters of CEUS [time to peak (TTP), peakintensity (PI), and enhancement rate (ER)] were compared among patients with different therapeutic effects. Spearmancorrelation coefficient model was used to analyze the correlation between CEUS quantitative parameters and the abla-tion efficacy and short-term prognosis of PLC patients. Results The remission rate of PLC treated by ultra-sound-guided radiofrequency ablation was 85.45%. The TTP of complete remission patients was significantly greaterthan that of partial remission patients, stable and progressive patients, while PI and ER were significantly lower, withstatistically significant differences (P<0.05). Spearman correlation coefficient model analysis showed that the ablationefficacy of PLC patients was positively correlated with TTP, and negatively correlated with PI and ER (P<0.05). Therecent prognosis of PLC patients is positively correlated with TTP (r=0.723，P<0.05), but negatively correlated with PIand ER (r=-0.765, -0.843, P<0.05). According to the analysis of the receiver operating characteristic (ROC) curve,the area under the curve (AUC) of TTP, PI, and ER in combination for predicting short-term prognosis of death was0.937. Decision curve analysis (DCA) analysis showed that the combination of TTP, PI, and ER has good clinical effi-cacy in predicting the short-term prognosis of PLC patients undergoing ablation treatment. Conclusion The quantita-tive parameters of CEUS (TTP, PI, ER) are closely related to the ablation efficacy and short-term prognosis of PLCpatients, and the combination of TTP, PI, and ER can provide reliable reference for clinical prediction of short-termprognosis.
      【Key words】 Primary liver cancer; Ultrasound-guided radiofrequency ablation; Ultrasonography; Efficacy; Prog-nosis