转化医学杂志

目的 探讨超声参数联合肝动脉参数、C反应蛋白（CRP）对肝癌介入治疗不良预后及复发预测价值。方法 回顾性选取2019年5月1日至2022年12月31日于保定市第二中心医院接受介入治疗且完成1年随访的300例肝癌患者资料，全部患者治疗前均行超声检查，测定超声造影参数[达峰时间（TTP）、峰值强度（PI）、平均通过时间（MTT）]、肝动脉血流参数（阻力指数、搏动指数），并测定血清CRP水平；统计肝癌患者介入治疗后3个月预后情况，并调查良好预后患者随访1年内复发情况，绘制受试者工作曲线（ROC），分析超声参数联合肝动脉参数、CRP对肝癌介入治疗不良预后及复发的预测价值。结果 300例肝癌患者介入术后不良预后106例，良好预后194例；不良预后肝癌患者TTP、MTT、阻力指数、搏动指数低于良好预后患者，PI、CRP高于良好预后患者（P<0.05）;194例良好预后患者随访1年内复发56例；复发肝癌患者TTP、MTT、阻力指数、搏动指数低于无复发患者，PI、CRP高于无复发患者（P<0.05）；绘制ROC曲线发现，超声参数、肝动脉参数、CRP单独及联合检测预测肝癌患者介入治疗不良预后、复发风险的AUC﹥0.70，均有一定预测价值。结论 超声参数联合肝动脉参数、CRP对肝癌患者介入治疗不良预后及复发具有较高价值。

Objective To explore the predictive value of ultrasound parameters combined with hepatic artery parameters and C-reactive protein(CRP) for poor prognosis and recurrence in interventional treatment of liver cancer.Methods A retrospective collection of data from 300 liver cancer patients who received interventional treatment and completed one-year follow-up in the hospital from May 1, 2019 to December 31, 2022. All patients underwent ultrasound examination before treatment, and ultrasound contrast parameters [time to peak(TTP), peak intensity(PI), mean transit time(MTT)], hepatic artery blood flow parameters(resistance index, pulsatility index), and serum CRP levels were measured; Statistical analysis of the 3-month prognosis of liver cancer patients after interventional treatment, and investigation of recurrence within 1 year of follow-up in patients with good prognosis. Receiver operating characteristic(ROC) curves were plotted to analyze the predictive value of ultrasound parameters combined with hepatic artery parameters and CRP for poor prognosis and recurrence of liver cancer after interventional treatment.Results Among 300 liver cancer patients, 106 had poor prognosis after interventional surgery, while 194 had good prognosis; TTP, MTT, resistance index and pulsatility index in patients with poor prognosis of liver cancer were lower than those in patients with good prognosis, while PI and CRP were higher than those in patients with good prognosis(P< 0. 05); Among 194 patients with good prognosis, 56 cases relapsed within 1 year of follow-up; The TTP,MTT, resistance index and pulsatility index of recurrent liver cancer patients were lower than those of non recurrent patients,while the PI and CRP were higher than those of non recurrent patients(P< 0. 05); By plotting ROC curves, it was found that ultrasound parameters, hepatic artery parameters, and CRP alone and in combination had a predictive value of AUC > 0. 70 for predicting poor prognosis and recurrence risk in liver cancer patients undergoing interventional therapy.Conclusion Ultrasound parameters combined with hepatic artery parameters and CRP have high value in predicting poor prognosis and recurrence in liver cancer patients undergoing interventional therapy.