CAJ | 학술논문

目的分析肝硬化背景下细胞角蛋白19（CK19）表达阳性与阴性的肝细胞癌（HCC）超声造影量化参数的差异。方法收集2005年6月至2013年10月第三军医大学西南医院收治的164例经手术或穿刺活检病理证实为HCC及肝硬化患者超声造影检查资料，其中79例患者CK19阳性，85例患者CK19阴性。使用DFY-Ⅱ型超声图像定量分析仪分别测量、计算CK19阳性与CK19阴性HCC超声造影动脉期增强不均匀度、峰值强度，超声造影门脉期增强强度，肿瘤及肿瘤旁肝实质超声造影门脉期增强强度比值，并进行比较。结果 CK19阳性HCC超声造影动脉期增强不均匀度高于CK19阴性HCC（2.64±0.64 vs 2.29±0.31），CK19阳性HCC超声造影动脉期峰值强度低于CK19阴性HCC[（102.83±29.78）dB vs（120.65±25.49） dB]，CK19阳性HCC超声造影门脉期增强强度低于CK19阴性HCC[（66.83±20.13） dB vs（79.99±27.15） dB]，CK19阳性HCC肿瘤与肿瘤旁肝实质超声造影门脉期增强强度比值低于CK19阴性HCC（0.74±0.03 vs 0.92±0.22），且差异均有统计学意义（W=4.4，P=0.000；t=3.887，P=0.000；t=3.115，P=0.002；t=5.221，P=0.000）。结论肝硬化背景下CK19不同表达的HCC超声造影量化参数存在明显差异。
목적분석간경화배경하세포각단백19（CK19）표체양성여음성적간세포암（HCC）초성조영양화삼수적차이。방법수집2005년6월지2013년10월제삼군의대학서남의원수치적164례경수술혹천자활검병리증실위HCC급간경화환자초성조영검사자료，기중79례환자CK19양성，85례환자CK19음성。사용DFY-Ⅱ형초성도상정량분석의분별측량、계산CK19양성여CK19음성HCC초성조영동맥기증강불균균도、봉치강도，초성조영문맥기증강강도，종류급종류방간실질초성조영문맥기증강강도비치，병진행비교。결과 CK19양성HCC초성조영동맥기증강불균균도고우CK19음성HCC（2.64±0.64 vs 2.29±0.31），CK19양성HCC초성조영동맥기봉치강도저우CK19음성HCC[（102.83±29.78）dB vs（120.65±25.49） dB]，CK19양성HCC초성조영문맥기증강강도저우CK19음성HCC[（66.83±20.13） dB vs（79.99±27.15） dB]，CK19양성HCC종류여종류방간실질초성조영문맥기증강강도비치저우CK19음성HCC（0.74±0.03 vs 0.92±0.22），차차이균유통계학의의（W=4.4，P=0.000；t=3.887，P=0.000；t=3.115，P=0.002；t=5.221，P=0.000）。결론간경화배경하CK19불동표체적HCC초성조영양화삼수존재명현차이。
Objective To explore contrast-enchancement ultrasound (CEUS) parameters of hepatocellular carcinoma (HCC) with different cytokeratin-19 (CK19) expression in the background of cirrhosis.Methods CEUS data of pathologically proven HCC in patients with cirrhosis in Southwest Hospital from June 2005 to October 2013 were collected in this retrospective study. Two groups were classified on the basis of different CK19 expression in HCC patients: CK19 positive group (seventy-nine patients) and CK19 negative group (eighty-ifve patients). DFY-II Ultrasound Imaging Analysis Software was utilized to measure and calculate CEUS paramrters, including the enhancement heterogeneity of the tumor and peak intensity in arterial phase, the enhancement intensity of tumor and the enhancement ratio of tumor/adjacent liver parenchyma in portal phase. The difference between the two groups was compared by statistics test. Results TThe arterial phase enhancement heterogeneity of tumor in CK19 positive group was higher than that of the negative group (2.64±0.64 vs 2.29±0.31). The arterial phase peak intensity of tumor in CK19 positive group was lower than that of the negative group [(102.83±29.78)dB vs (120.65±25.49)dB]. The portal phase enhancement intensity of tumor in CK19 positive group was lower than that of the negative group [(66.83±20.13) dB vs (79.99±27.15) dB ].The enhancement ratio of tumor/adjacent liver parenchyma in portal phase was lower in CK19 positive group than that in the negative group (0.74±0.03 vs 0.92±0.22). All above comparisons had significant differences between two group. Conclusions The CEUS enhancement parameters had signiifcant difference between the CK19 positive HCC and negative HCC in patient with background cirrhosis.