国际医学放射学杂志2025，Vol.48Issue(5)：535-540,554,7.DOI:10.19300/j.2025.L21858
钆塞酸二钠增强MRI联合CK19及微血管侵犯对肝细胞癌术后复发的预测价值
Predictive value of gadoxetic acid-enhanced MRI combined with CK19 and microvascular invasion for postoperative recurrence of hepatocellular carcinoma
摘要
Abstract
Objective To investigate the predictive value of gadoxetic acid-enhanced MRI features and clinicopathological characteristics for postoperative recurrence in patients with hepatocellular carcinoma(HCC).Methods A retrospective cohort of 209 patients with pathologically confirmed HCC who underwent surgical resection was analyzed.Based on postoperative follow-up results,patients were divided into a recurrence group(n=82)and a non-recurrence group(n=127).Clinicopathological parameters and MRI features were compared between groups.A nomogram model for predicting postoperative recurrence-free survival(RFS)in HCC patients was constructed based on the results of multivariate Cox regression analysis.Model performance was assessed using receiver operating characteristic(ROC)curve analysis,calibration curve analysis,and decision curve analysis(DCA).Kaplan-Meier curves were generated to compare RFS between subgroups,and the Log-rank test was used for statistical comparison.Results Multivariate Cox regression identified CK19 positivity,microvascular invasion(MVI)positivity,and the presence of the mosaic sign as independent risk factors for postoperative recurrence of HCC(all P＜0.05).The nomogram model demonstrated a higher area under the ROC curve(AUC)compared with any single factor(CK19,MVI,or mosaic sign).The model showed good fit and calibration,and DCA demonstated good clinical utility.Median RFS was 30 months for CK19-positive patients,17 months for MVI-positive patients,and 26 months for patients with mosaic sign positivity.Differences in 1-,2-,and 3-year RFS rates according to CK19,MVI,and mosaic sign status were statistically significant(Log-rank test,all P＜0.05).Conclusion CK19 positivity,MVI positivity,and mosaic sign positivity are independent risk factors for postoperative recurrence of HCC,and may serve as potential biomarkers for predicting poor prognosis after curative resection.关键词
肝细胞癌/磁共振成像/细胞角蛋白19/微血管侵犯/无复发生存率Key words
Hepatocellular carcinoma/Magnetic resonance imaging/Cytokeratin-19/Microvascular invasion/Recurrence-free survival分类
医药卫生引用本文复制引用
王绍刚,张涛,张学琴,徐磊..钆塞酸二钠增强MRI联合CK19及微血管侵犯对肝细胞癌术后复发的预测价值[J].国际医学放射学杂志,2025,48(5):535-540,554,7.基金项目
南通市卫生健康委科研课题(指令性)面上项目(MS2023071) （指令性）
