cfDNA检测联合肝脏MRI在肝细胞癌筛查中的应用价值

徐娟; 辛杰晶; 李毅; 吕其军; 冯雪; 黄海燕

doi:10.12019/j.issn.1671-5144.2022.04.005

cfDNA检测联合肝脏MRI在肝细胞癌筛查中的应用价值

徐娟¹,
辛杰晶²,
李毅¹,
吕其军¹,
冯雪¹,
黄海燕^1, ,

1.
胜利油田中心医院感染病科, 山东东营 257034
2.
延安大学附属医院感染病科, 陕西延安 716000

详细信息

作者简介:
徐娟（1983-）,女,山东淄博人,主治医师,医学硕士,主要研究方向为各种类型肝病及肝癌早筛。

通讯作者:
黄海燕, Tel: 0546-8770483, E-mail: huanghaiyan_happy@163.com。

中图分类号: R735.7
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出版历程
- 收稿日期: 2021-04-29
- 发布日期: 2022-08-27

The Application Value of cfDNA Detection Combined With Liver MRI in the Screening of Hepatocellular Carcinoma

1.
Department of Infectious Diseases, Central Hospital of Shengli Oilfield, Shandong Dongying 257034, China
2.
Department of Infectious Diseases, Affiliated Hospital of Yan'an University, Shaanxi Yan'an 716000, China

摘要

摘要: 目的评估循环游离细胞DNA（circulating free DNA,cfDNA）检测联合肝脏核磁共振成像（magnetic resonance imaging,MRI）在肝细胞癌筛查中的应用价值。方法选择126例高度疑似肝癌的患者为研究对象,根据病理学检查结果,其中82例为肝癌患者（肝癌组）,44例为良性肿瘤患者（良性组）,比较两组患者cfDNA、RNaseP基因（cfDNA池基因编码DNA的参考基因）拷贝、肝功能指标,包括丙氨酸转氨酶（alanine transaminase,ALT）、天冬氨酸转氨酶（aspartate transaminase,AST）、碱性磷酸酶（alkaline phosphatase,ALP）及肿瘤标志物水平,包括甲胎蛋白（alpha-fetoprotein,AFP）、癌胚抗原（carcinoembryonic antigen,CEA）、糖链抗原199（carbohydrate antigen,CA199）。比较cfDNA水平与肝细胞癌病理参数的关系,并评估RNaseP联合MRI在肝细胞癌中的诊断效能。结果肝癌组的cfDNA、RNaseP基因拷贝、AFP、CEA、CA199、ALT、AST、ALP均明显高于良性组,差异均具有统计学意义（P<0.05）。肝癌患者的Child-Pugh评分、终末期肝病模型评分、肿瘤大小、转移、酒精性肝炎阳性在低cfDNA（<20 ng/mL）组和高cfDNA（≥20 ng/mL）组均具有统计学差异（P<0.05）。RNaseP基因检测联合MRI在HCC诊断的灵敏度明显高于RNaseP基因液体活检（χ²=9.043,P=0.003）和MRI（χ²=7.12,P=0.006）。结论肝细胞癌患者的cfDNA明显升高,cfDNA水平高低与肝细胞癌病理参数相关,cfDNA的参考基因RNaseP检测联合MRI对肝细胞癌筛查具有更优的应用价值。
- cfDNA /
- RNaseP /
- MRI /
- 肝细胞癌 /
- 筛查
Abstract: Objective To evaluate the application value of cfDNA detection combined with liver MRI in the screening of hepatocellular carcinoma. Methods 126 patients with highly suspected liver cancer were selected as the research objects. According to the results of pathological examination, 82 of them were hepatocellular cancer patients （hepatocellular cancer group） and 44 were benign tumor patients （benign group）. The two groups of cfDNA, RNaseP （cfDNA reference gene） gene copy, liver function indexes [alanine transaminase （ALT）, aspartate transaminase （AST）, alkaline phosphatase （ALP）] and tumor marker levels （alpha-fetoprotein （AFP）, carcinoembryonic antigen （CEA）, carbohydrate antigen （CA199） were compared. The relationship between cfDNA levels and pathological parameters of hepatocellular carcinoma was studied. And the diagnostic efficacy of RNaseP gene copy combined with MRI in hepatocellular carcinoma was evaluated. Results The cfDNA, RNaseP gene copy, AFP, CEA, CA199, ALT, AST and ALP of the liver cancer group were significantly higher than those of the benign group, and the differences were statistically significant （P<0.05）. The Child-Pugh score, end-stage liver disease model score, tumor size, metastasis, and alcoholic hepatitis positive of liver cancer patients were statistically significant in the low cfDNA （<20 ng/mL） group and high cfDNA （≥20 ng/mL） group Difference （P<0.05）. The sensitivity of RNaseP gene copy combined with MRI in the diagnosis of hepatocellular cancer was significantly higher than that of RNaseP gene copy （χ²=9.043, P=0.003） and MRI （χ²=7.12, P=0.006）. Conclusions The cfDNA of patients with hepatocellular carcinoma was significantly increased. The level of cfDNA was related to the pathological parameters of hepatocellular carcinoma. cfDNA reference gene RNaseP detection combined with MRI had better application value for screening of hepatocellular carcinoma.
- cfDNA /
- RNaseP /
- MRI /
- hepatocellular carcinoma /
- early screening

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参考文献(19)

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