The predictive value of contrast-enhanced ultrasonography combined with aspartate aminotransferase-to-lymphocyte ratio in predicting therapeutic efficacy and prognosis of post-transarterial chemoembolization in primary liver cancer

IF 1.7 4区综合性期刊 Q2 MULTIDISCIPLINARY SCIENCES Journal of Radiation Research and Applied Sciences Pub Date : 2024-10-09 DOI:10.1016/j.jrras.2024.101111

Zhiyu Hao

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Abstract

Objective

To investigate the predictive value of contrast-enhanced ultrasonography (CEUS) combined with the aspartate aminotransferase-to-lymphocyte ratio (ALRI) in predicting the therapeutic efficacy and prognosis of primary liver cancer after transarterial chemoembolization (TACE).

Methods

We included 75 patients with hepatocellular carcinoma (HCC) who underwent TACE in our oncology department between January 2019 and December 2021. The patients' clinical data, preoperative ALRI, and postoperative CEUS results were analyzed.

Results

The optimal cutoff value of ALRI for predicting residual tumor lesions using digital subtraction angiography (DSA) was 42.50. CEUS had a specificity of 0.92, sensitivity of 0.96, and area under the curve (AUC) of 0.940 for determining residual tumor lesions, while ALRI had a specificity of 0.88, sensitivity of 0.70, and AUC of 0.825. The combination of CEUS and ALRI provided a specificity of 0.92, sensitivity of 0.98, and AUC of 0.985 for determining residual tumor lesions. All patients were followed up continuously after the operation. The optimal cutoff value of ALRI for predicting residual tumor lesions in relation to 3-year survival was 41.50. In terms of 3-year survival prediction, DSA showed a specificity of 0.559, sensitivity of 0.889, and AUC of 0.724, CEUS exhibited a specificity of 0.500, sensitivity of 0.852, and AUC of 0.676, and ALRI had a specificity of 0.618, sensitivity of 0.704, and AUC of 0.611. Combined detection of CEUS and ALRI resulted in a specificity of 0.500, sensitivity of 0.889, and AUC of 0.662 for predicting 3-year survival. Patients with negative DSA results, CEUS-negative patients, and those with ALRI ≤41.5 exhibited significantly better survival outcomes compared to their positive counterparts.

Conclusion

CEUS combined with ALRI yields a higher predictive value in predicting residual tumor lesions and death in patients with HCC after TACE.

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对比增强超声造影结合天冬氨酸氨基转移酶-淋巴细胞比值在预测原发性肝癌经动脉化疗栓塞术后疗效和预后中的预测价值

目的研究对比增强超声成像（CEUS）结合天冬氨酸氨基转移酶与淋巴细胞比值（ALRI）在预测原发性肝癌经动脉化疗栓塞术（TACE）后疗效和预后方面的预测价值。方法纳入2019年1月至2021年12月期间在我院肿瘤科接受TACE治疗的75例肝细胞癌（HCC）患者。结果使用数字减影血管造影（DSA）预测残留肿瘤病灶的最佳ALRI临界值为42.50。CEUS 对确定残留肿瘤病灶的特异性为 0.92，敏感性为 0.96，曲线下面积 (AUC) 为 0.940，而 ALRI 的特异性为 0.88，敏感性为 0.70，曲线下面积 (AUC) 为 0.825。CEUS 和 ALRI 联合用于确定残留肿瘤病灶的特异性为 0.92，灵敏度为 0.98，AUC 为 0.985。术后对所有患者进行了持续随访。ALRI预测残留肿瘤病灶与3年生存率的最佳临界值为41.50。在预测 3 年生存率方面，DSA 的特异性为 0.559，敏感性为 0.889，AUC 为 0.724；CEUS 的特异性为 0.500，敏感性为 0.852，AUC 为 0.676；ALRI 的特异性为 0.618，敏感性为 0.704，AUC 为 0.611。联合检测 CEUS 和 ALRI 预测 3 年生存率的特异性为 0.500，灵敏度为 0.889，AUC 为 0.662。DSA结果阴性的患者、CEUS结果阴性的患者以及ALRI≤41.5的患者与阳性患者相比，生存率明显更高。

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来源期刊

Journal of Radiation Research and Applied Sciences MULTIDISCIPLINARY SCIENCES-

自引率

5.90%

发文量

130

审稿时长

16 weeks

期刊介绍： Journal of Radiation Research and Applied Sciences provides a high quality medium for the publication of substantial, original and scientific and technological papers on the development and applications of nuclear, radiation and isotopes in biology, medicine, drugs, biochemistry, microbiology, agriculture, entomology, food technology, chemistry, physics, solid states, engineering, environmental and applied sciences.