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

doi:10.3969/j.issn.1006-5725.2025.16.019

Abstract

Abstract:

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.

Key words: hepatocellular carcinoma, intervention therapy, contrast-enhanced ultrasound parameters, chemokine ligand 9, insulin-like growth factor binding protein 3

CLC Number:

R735.7

Min MO,Jingjing LIN,Xin LU,Jin. LU. The predictive value of contrast‑enhanced ultrasound parameters combined with serum CXCL9 and IGFBP‑3 for recurrence of hepatocellular carcinoma after interventional therapy[J]. The Journal of Practical Medicine, 2025, 41(16): 2568-2574.

Figures/Tables 8

Tab.1

Comparison of clinical data between the two groups"

临床资料	A组（n = 61）	B组（n = 151）	t/χ² 值	P值
性别			0.766	0.381
男	46（75.41）	122（80.79）
女	15（24.59）	29（19.21）
年龄（ $x ˉ$ ± s）/岁	56.58 ± 9.73	56.92 ± 9.21
肝功能Child-Pugh分级			2.544	0.111
A级	35（57.38）	104（68.87）
B级	26（42.62）	47（31.13）
病灶位置			0.044	0.834
肝左叶	26（42.62）	62（41.06）
肝右叶	35（57.38）	89（58.94）
病理类型			1.087	0.297
腺癌	32（52.46）	91（60.26）
鳞状细胞癌	29（47.54）	60（39.74）
肿瘤最大径			7.590	0.006
≤ 3 cm	32（52.46）	109（72.19）
> 3 cm	29（47.54）	42（27.81）
微血管侵犯			6.069	0.014
有	36（59.02）	61（40.04）
无	25（40.98）	90（59.60）

Tab.1

Tab.2

Tab.3

Tab.4

Tab.5

Fig.1

Fig.2

Fig.3

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指标	A组（n = 61）	B组（n = 151）	t值	P值
PI/dB	140.87 ± 12.78	130.93 ± 12.69	5.513	< 0.001
TTP/s	16.48 ± 1.97	18.41 ± 1.74	7.034	< 0.001
AT/s	19.02 ± 1.05	20.13 ± 1.25	6.116	< 0.001
CXCL9/（pg/mL）	921.43 ± 35.51	869.63 ± 35.37	9.642	< 0.001
IGFBP-3/（mg/L）	4.89 ± 1.09	5.87 ± 1.08	5.965	< 0.001

因素	赋值
肿瘤最大径	≤ 3 cm = 0，> 3 cm = 1
微血管侵犯	无 = 0，有 = 1
PI	原值输入
TTP	原值输入
AT	原值输入
CXCL9	原值输入
IGFBP-3	原值输入

变量	β	SE	Wald/χ²	P值	OR	95%CI
肿瘤最大径> 3 cm	0.787	0.387	4.135	0.042	2.197	1.029 ~ 4.690
有微血管侵犯	0.907	0.342	7.033	0.008	2.477	1.267 ~ 4.842
PI高	1.043	0.387	7.264	0.007	2.838	1.329 ~ 6.059
TTP短	0.687	0.117	34.478	0.000	1.988	1.580 ~ 2.500
AT短	0.821	0.279	8.659	0.003	2.273	1.315 ~ 3.927
CXCL9水平高	0.819	0.296	7.656	0.006	2.268	1.270 ~ 4.052
IGFBP-3水平低	0.905	0.308	8.634	0.003	2.472	1.352 ~ 4.521

指标	AUC	P值	95%CI	截断值	敏感度/%	特异度/%	约登指数
PI	0.731	< 0.001	0.665 ~ 0.789	133.55 dB	75.41	62.91	0.383
TTP	0.799	< 0.001	0.739 ~ 0.851	16.83 s	62.30	92.05	0.544
AT	0.755	< 0.001	0.691 ~ 0.811	19.25 s	75.41	73.51	0.489
CXCL9	0.814	< 0.001	0.755 ~ 0.864	889.70 pg/mL	85.25	68.21	0.535
IGFBP-3	0.824	< 0.001	0.765 ~ 0.872	5.68 mg/L	85.25	65.56	0.508
联合	0.902^*#&▲?	< 0.001	0.854 ~ 0.938		81.97	84.77	0.667

The predictive value of contrast‑enhanced ultrasound parameters combined with serum CXCL9 and IGFBP‑3 for recurrence of hepatocellular carcinoma after interventional therapy

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