MRI联合血清GPC3水平鉴别肝脏结节性增生病灶临床应用价值研究*

doi:10.3969/j.issn.1672-5069.2022.01.022

Abstract

Abstract: Objective The aim of this study was to investigate the diagnostic value of magnetic resonance imaging (MRI)and serum glypican 3 (GPC3) levels in patients with nodular regenerative hyperplasia (NRH). Methods A total of 79 patients with NRH were admitted to our hospital between March 2016 and August 2019. Serum GPC3 levels were detected by ELISA, and all patients underwent MRI scan. After finishing the check-up, all patients received hepatectomy. The differential value of MRI and serum GPC3 levels for the four types of hepatic lesions was analyzed by receiver operating characteristic (ROC) curves. Results The post-operational histopathological examination showed focal nodular hyperplasia (FNH) in 25 cases, liver cell adenoma (LCA) in 18 cases, dysplasia nodule(DN) in 20 cases and hepatocellular carcinoma (HCC) in 16 cases; serum GPC3 level in patients with HCC was (2.2±0.4) ng/ml, significantly higher than (1.0±0.2) ng/ml in patients with FNH, or (1.2±0.2) ng/ml in patients with LCA (P<0.05), while serum GPC3 level in patients with DN was (1.8±0.3) ng/ml, not significantly different compared to that in patients with HCC (P>0.05); the accuracy by MRI in diagnosing HCC, DN, FNH and LCA were 88.0%(22/25), 88.9%(16/18), 70.0%(14/20) and 75.0%(12/16), not significantly different (P>0.05); the AUC of MRI and serum GPC3 level combination in diagnosing HCC was 0.760, significantly higher than in other three hepatic lesions (0.610, 0.611 and 0.614, respectively, P<0.05). Conclusion MRI and serum GPC3 level combination in distinguishing hepatic NRH is promising and efficacious, which warrants further clinical investigations.

Key words: Nodular regenerative hyperplasia, MRI, Glypican 3, Diagnosis

Tan Yuying, Zhang Xin, Zhang Juanzi, et al. Diagnostic value of MRI and serum GPC3 levels in patients with nodular regenerative hyperplasia[J]. Journal of Practical Hepatology, 2022, 25(1): 88-91.

References

[1] Barge S, Grando V, Nault JC, et al. Prevalence and clinical significance of nodular regenerative hyperplasia in liver biopsies. Liver Int, 2016, 36(7):1059-1066.
[2] Gu K, Jeon TY, Yoo SY, et al. Gd-EOB-DTPA MRI for focal nodular hyperplasia-like lesions in pediatric cancer survivors. Eur Radiol, 2021, 31(1):283-291.
[3] 汤笑禹, 王砚春, 卢仁泉, 等. 血清GPC3水平在原发性肝细胞癌患者辅助诊断中的应用价值. 中华预防医学杂志, 2020, 54(9):998-1002.
[4] Seinen ML, van Asseldonk DP, de Boer NK, et al. Nodular regenerative hyperplasia of the liver in patients with IBD treated with allopurinol-thiopurine combination therapy. Inflamm Bowel Dis, 2017, 23(3):448-452.
[5] Cannella R, Rangaswamy B, Minervini MI, et al. Value oftexture analysis on gadoxetic acid-enhanced MRI for differentiating hepatocellular adenoma from focal nodular hyperplasia. AJR, 2019, 212(3):538-546.
[6] 高德军, 陈耀康, 罗鹰, 等. 3.0 T MR-LAVA序列多期动态增强扫描对肝硬化结节病变定性诊断的临床价值研究.实用肝脏病杂志, 2019, 22(3):96-99.
[7] Choi SH, Kim KW, Kwon HJ, et al. Clinical usefulness of gadoxetic acid-enhanced MRI for evaluating biliary anatomy in living donor liver transplantation. Eur Radiol, 2019, 29(12):6508-6518.
[8] Badea R, Meszaros M, Al Hajjar N, et al. Benign nodular hyperplasia of the liver-pedunculated form: diagnostic contributions of ultrasonography and consideration of exophytic liver tumors. J Med Ultrason, 2015, 42(1):97-102
[9] Sonomura T, Anami S, Takeuchi T, et al. Reactive lymphoid hyperplasia of the liver:Perinodular enhancement on contrast-enhanced computed tomography and magnetic resonance imaging. World J Gastroenterol, 2015, 21(21):6759-6763.
[10] 方勇超, 王强, 唐权, 等. MSCT与MRI动态增强扫描对高血供肝内胆管癌与肝细胞癌的诊断价值分析. 实用肝脏病杂志, 2020, 23(6):131-134.
[11] Nowicki TK, Markiet K, Izycka-Swieszewska E, et al. Efficacy comparison of multi-phase CT and hepatotropic contrast-enhanced MRI in the differential diagnosis of focal nodular hyperplasia: a prospective cohort study. BMC Gastroenterol, 2018, 18(1):10-14.
[12] Guo Y, Li W, Xie Z, et al. Diagnosticvalue of Gd-EOB-DTPA-MRI for hepatocellular adenoma: A Meta-analysis. J Cancer, 2017, 8(7):1301-1310.
[13] 李烨, 刘爱连, 郭妍, 等. 动态对比增强磁共振成像Ktrans与HPI纹理分析对肝细胞癌及结直肠癌肝转移瘤的鉴别价值. 中华临床医师杂志:电子版, 2018, 12(9):512-517.
[14] Suh CH, Kim KW, Park SH, et al. A cost-effectiveness analysis of the diagnostic strategies for differentiating focal nodular hyperplasia from hepatocellular adenoma. Eur Radiol, 2018, 28(1):214-225.
[15] 汪禾青, 杨春, 盛若凡, 等. 肝脏局灶性结节性增生与炎症型肝细胞腺瘤的MRI表现和鉴别诊断. 中华肝胆外科杂志, 2018, 24(6):361-366.
[16] Shiozawa K, Watanabe M, Ikehara T, et al. Comparison of contrast-enhanced ultrasonograpy with Gd-EOB-DTPA-enhanced MRI in the diagnosis of liver metastasis from colorectal cancer. J Clin Ultrasound, 2017, 45(3):138-144.
[17] 吴燕京. 19例肝脏局灶性结节性增生的临床和影像学特点. 中华消化杂志, 2015, 35(2):95-98.
[18] Wang Q, Guo Y, Zhang J, et al. Contribution of IVIM toconventional dynamic contrast enhanced and diffusion-weighted MRI in differentiating benign from malignant breast masses. Breast Care (Basel), 2016, 11(4):254-258.
[19] Kim B, Byun JH, Lee JH, et al. Imaging findings of primary hepatic angiosarcoma on gadoxetate disodium-enhanced liver MRI: comparison with hepatic haemangiomas of similar size. Clin Radiol, 2018, 73(3):244-253.
[20] Gawande R, Jalaeian H, Niendorf E, et al. MRI in differentiating malignant versus benign portal vein thrombosis in patients with hepatocellular carcinoma: Value of post contrast imaging with subtraction. Eur J Radiol, 2019, 118(9):88-95.

Diagnostic value of MRI and serum GPC3 levels in patients with nodular regenerative hyperplasia

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