收稿日期: 2025-06-04
网络出版日期: 2025-08-28
基金资助
湖南省卫生健康委科研计划项目(D202303086840)
The predictive value of contrast‑enhanced ultrasound parameters combined with serum CXCL9 and IGFBP‑3 for recurrence of hepatocellular carcinoma after interventional therapy
Received date: 2025-06-04
Online published: 2025-08-28
目的 分析超声造影参数联合血清趋化因子配体9（CXCL9）、胰岛素样生长因子结合蛋白-3（IGFBP-3）对肝癌介入治疗后复发的预测价值。 方法 选取2022年6月至2023年11月医院收治的212例肝癌介入治疗患者，根据介入治疗1年后是否复发分成A组（61例）和B组（151例）。采用多因素logistic回归分析探究肝癌介入治疗患者复发的影响因素，并采用受试者工作特征曲线（ROC曲线）分析超声造影参数联合血清因子对肝癌介入治疗后复发的预测价值。 结果 肿瘤最大径> 3 cm、有微血管侵犯、峰值强度（PI）高、达峰时间（TTP）短、到达时间（AT）短、血清CXCL9水平高及血清IGFBP-3水平低是肝癌介入治疗患者复发的独立危险因素（P < 0.05），PI、TTP、AT联合血清CXCL9、IGFBP-3检测预测肝癌介入治疗患者复发的曲线下面积（AUC）值高于其余单一因素检测（P < 0.05）。 结论 肝癌介入治疗患者复发风险较高，其独立危险因素涵盖多个方面，且超声造影参数、血清CXCL9、IGFBP-3联合可提高对肝癌介入治疗患者复发的预测价值。
关键词： 肝癌; 介入治疗; 超声造影参数; 趋化因子配体9; 胰岛素样生长因子结合蛋白-3
莫敏 , 林静静 , 卢鑫 , 卢瑾 . 超声造影参数联合血清CXCL9、IGFBP-3对肝癌介入治疗后复发的预测价值[J]. 实用医学杂志, 2025 , 41(16) : 2568 -2574 . DOI: 10.3969/j.issn.1006-5725.2025.16.019
Objective To evaluate the predictive significance of contrast?enhanced ultrasound parameters in combination with serum levels of chemokine ligand 9 (CXCL9) and insulin?like growth factor?binding protein 3 (IGFBP?3) for the recurrence of hepatocellular carcinoma following interventional therapy. Methods A total of 212 patients with liver cancer who received interventional therapy at the hospital between June 2022 and November 2023 were selected and categorized into Group A (61 cases) and Group B (151 cases) based on whether tumor recurrence occurred within one year following the intervention. Multivariate logistic regression analysis was conducted to identify potential influencing factors associated with post?treatment recurrence. The predictive performance of contrast?enhanced ultrasound parameters combined with serum biomarkers was evaluated using receiver operating characteristic (ROC) curve analysis. Results The levels of several factors including a tumor with a maximum diameter exceeding 3 cm, presence of microvascular invasion, high peak intensity (PI), short time to peak (TTP), short arrival time (AT), elevated serum CXCL9, and decreased serum IGFBP?3 were identified as independent risk factors for recurrence in patients with hepatocellular carcinoma following interventional therapy (P < 0.05). The area under the curve (AUC) for the combination of PI, TTP, AT, along with serum levels of CXCL9 and IGFBP?3, in predicting recurrence after interventional therapy was significantly higher than that of individual factors alone (P < 0.05). Conclusions The risk of recurrence in patients undergoing interventional therapy for liver cancer is substantial, and it is influenced by a range of independent risk factors. Combining contrast?enhanced ultrasound parameters with serum levels of CXCL9 and IGFBP?3 may enhance the predictive accuracy for tumor recurrence in these patients.
| [1] | 徐军红， 姚红兵， 王雪尧， 等. FOLFOX-肝动脉灌注化疗联合应用仑伐替尼和程序性死亡受体1抑制剂治疗中晚期肝癌［J］. 实用医学杂志， 2024， 40（6）： 762-767. |
| [2] | FUSTER-ANGLADA C， MAURO E， FERRER-FàBREGA J， et al. Histological predictors of aggressive recurrence of hepatocellular carcinoma after liver resection［J］. J Hepatol， 2024， 81（6）： 995-1004. doi:10.1016/j.jhep.2024.06.018 |
| [3] | BONNEY G K， CHEW C A， LODGE P，et al. Liver transplantation for non- resectable colorectal liver metastases： The International Hepato-Pancreato- Biliary Association consensus guidelines［J］. Lancet Gastroenterol Hepatol， 2021， 6（11）： 933-946. doi:10.1016/s2468-1253(21)00219-3 |
| [4] | 张健颖， 阮佳泉， 何坤燕， 等. 中晚期肝癌的超声造影与CT影像诊断及超声造影评估介入治疗疗效的价值研究［J］. 中国CT和MRI杂志， 2022， 20（11）： 109-111. |
| [5] | 王会哲， 卢双动， 王谦， 等. 超声参数联合肝动脉参数、C反应蛋白对肝癌介入治疗不良预后及复发预测价值［J］. 转化医学杂志， 2024， 13（7）： 1021-1026. |
| [6] | 王坤， 董怡， 刘凌晓， 等. CEUS在肝细胞肝癌局部热消融疗效评估中的临床应用价值［J］. 肿瘤影像学， 2022， 31（4）： 414-418. |
| [7] | BAI L， WANG X， SHI S， et al. Evaluation of 3D-CEUS in the Recurrence of Liver Cancer after Radiofrequency Ablation［J］. J Healthc Eng， 2021， 2021： 3123553. doi:10.1155/2021/3123553 |
| [8] | 汪亚丽， 郑茂， 果基牛牛， 等. 脱-γ-羧基凝血酶原对原发性肝癌TACE术后复发转移的预测价值［J］. 河北医药， 2024， 46（20）： 3070-3074. |
| [9] | 吴孟超， 汤钊猷， 刘允怡， 等. 原发性肝癌诊疗规范（2019年版）［J］. 中国实用外科杂志， 2020， 12（2）： 121-138. |
| [10] | LI Y， ZHANG R， XU Z， et al. Advances in Nanoliposomes for the Diagnosis and Treatment of Liver Cancer［J］. Int J Nanomedicine， 2022， 26（17）： 909-925. |
| [11] | GADALETA E， THORN G J， ROSS-ADAMS H， et al. Field cancerization in breast cancer［J］. J Pathol， 2022， 7（4）： 561-574. doi:10.1002/path.5902 |
| [12] | WU L， LAI Q， LI S， et al. Artificial intelligence in predicting recurrence after first-line treatment of liver cancer： A systematic review and meta-analysis［J］. BMC Med Imaging， 2024， 24（1）： 263. doi:10.1186/s12880-024-01440-z |
| [13] | 张瑶， 贾哲， 何楠， 等. 超声造影辅助超声引导射频消融术治疗原发性肝癌疗效分析［J］. 中国超声医学杂志， 2021， 37（8）： 892-896. |
| [14] | KATAGIRI M， SUDO T， TOUNANN T， et al. Development of an Algorithm to Predict Recurrences After Resection of Liver Metastases in Patients With Metastatic Colorectal Cancer［J］. Anticancer Res， 2023， 43（8）： 3807-3816. doi:10.21873/anticanres.16567 |
| [15] | SHUR J， KAFAEI L， RIDDELL A， et al. Enhancement of colorectal cancer liver metastases with gadoxetate-enhanced MRI atmultiple time points is associated with disease-free survival followinghepatectomy［J］. Br J Radiol， 2025， 98（1169）： 744-751. doi:10.1093/bjr/tqaf040 |
| [16] | XIA Y， LI J， LIU G， et al. Long-term Effects of Repeat Hepatectomy vs Percutaneous Radiofrequency Ablation Among Patients With Recurrent Hepato cellular Carcinoma： A Randomized Clinical Trial［J］. JAMA Oncol， 2020， 6（2）： 255-263. doi:10.1001/jamaoncol.2019.4477 |
| [17] | HUANG A， GUO D Z， ZHANG X， et al. Serial circulating tumor DNA profiling predicts tumor recurrence after liver transplantation for liver cancer［J］. Hepatol Int， 2024， 18（1）： 254-264. doi:10.1007/s12072-023-10594-x |
| [18] | BUISMAN F E， FILIPE W F， KEMENY N E， et al. Recurrence After Liver Resection of Colorectal Liver Metastases： Repeat Resection or Ablation Followed by Hepatic Arterial Infusion Pump Chemotherapy［J］. Ann Surg Oncol， 2021， 28（2）： 808-816. doi:10.1245/s10434-020-08776-0 |
| [19] | LIU F， HOU B， LI Z， et al. Microwave ablation ofmultifocal prim ary liver cancer guided by real-time 3.0 T MRI［J］. Int J Hyperthermia， 2023， 40（1）： 2228519. doi:10.1080/02656736.2023.2228519 |
| [20] | 姜波， 费翔， 范小伟， 等. 术前应用全氟丁烷超声造影在评估肝细胞癌微血管侵犯和术后复发中的临床应用价值［J］. 中华肝胆外科杂志， 2021， 27（12）： 894-899. |
| [21] | SERBANESCU-KELE APOR DE ZALáN C M C， RUITER S J S， VAN DEN BERG A P， et al. Outcomes after primary and repeat thermal ablation of hepatocellular carcinoma with or without liver transplantation［J］. Eur Radiol， 2022， 32（6）： 4168-4176. doi:10.1007/s00330-021-08515-3 |
| [22] | INOUE Y， SUZUKI Y， OTA M， et al. The Management of Recurrence of Hepatocellular Carcinoma Occurring Within 6 Months After Hepatic Resection： A Comparative Study Using a Propensity Score Matching Analysis［J］. J Gastrointest Cancer， 2022， 53（2）： 272-281. doi:10.1007/s12029-021-00585-2 |
| [23] | LI M S， HOU Z H， YAO G Z， et al. The strategy and efficacy of prophylaxis against hepatitis B virus recurrence after liver transplantation for HBV-related diseases in the era of potent nucleos（t）ide analogues： A meta-analysis［J］. J Dig Di， 2021， 22（2）： 91-101. doi:10.1111/1751-2980.12959 |
| [24] | 卢长宇， 田野， 陶博， 等. 术前超声造影对肝癌介入术后微血管侵犯及早期复发的预测价值［J］. 中国超声医学杂志， 2022， 38（10）： 1119-1123. |
| [25] | WANG Y， ZHAO Y， LI M， et al. Conversion of primary liver cancer after targeted therapy for liver cancer combined with AFP-targeted CAR T-cell therapy： A case report［J］. Front Immunol， 2023，15（14）： 1180001. |
| [26] | ZHAO Y， ZHANG C， ZHANG Y， et al. Effects of image-guided adaptive radiotherapy combined with hepatic artery chemoembolization in primary liver cancer patients［J］. Clin Res Hepatol Gastroenterol， 2022， 46（5）： 101889. doi:10.1016/j.clinre.2022.101889 |
| [27] | SAWANO H， MATSUOKA H， MIZUNO T， et al. Risk factors for residual liver recurrence of colorectal cancer after resection of liver metastases and significance of adjuvant chemotherapy［J］. Asian J Surg， 2024， 47（12）： 5124-5130. doi:10.1016/j.asjsur.2024.07.001 |
| [28] | LINE P D， DUELAND S. Liver transplantation for secondary liver tumours： The difficult balance between survival and recurrence［J］. J Hepatol， 2020， 73（6）： 1557-1562. doi:10.1016/j.jhep.2020.08.015 |
| [29] | LI D， ZHANG K， WANG K， et al. Sono-blasting Triggered Cascading-Amplification of Oxidative Stress for Enhanced Interventional Therapy of Hepatocellular Carcinoma［J］. Nano Lett， 2024， 24（29）： 8996-9003. doi:10.1021/acs.nanolett.4c02027 |
| [30] | LAO Q， WU X， ZHENG X， et al. Effect of Tacrolimus Time in Therapeutic Range on Postoperative Recurrence in Patients Undergoing Liver Transplantation for Liver Cancer［J］. Ther Drug Monit， 2024， 46（1）： 42-48. doi:10.1097/ftd.0000000000001119 |
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