医学
肝细胞癌
内科学
肝病学
结核(地质)
胃肠病学
甲胎蛋白
核医学
生物
古生物学
作者
Chaoqun Li,Hui Huang,Si‐Min Ruan,Shunro Matsumoto,Meng‐Fei Xian,Xiaoyan Xie,Ming‐De Lu,Ming Kuang,Guangzhi Wang,Li‐Da Chen
标识
DOI:10.1007/s00261-022-03428-1
摘要
Purpose To improve noninvasive diagnosis of HCC using a combination of CE US LI-RADS and alpha-fetoprotein (AFP).Methods757 solitary liver nodules from 757 patients at risk of HCC with CE US and serum AFP test were categorized as LR-1 to LR-5 through LR-M according to CE US LI-RADS version 2017. In LR-3, LR-4, and LR-M nodules, those with AFP > 200 ng/ml were reclassified as mLR-5. Nodules with LR-5 and mLR-5 were reclassified as definitely HCC to modify CE US LI-RADS. Diagnostic performance was assessed with specificity, sensitivity, and PPV.ResultsThe sensitivity, specificity, and PPV of LR-5 as a predictor of HCC were 64.7%, 97.8%, and 98.9%, respectively. 32.1% patients with solitary liver nodule had AFP greater than 200 ng/ml, of which 98.8% were HCC (25.8%, 7.5%, 2.5% assigned to LR-M, LR-4, LR-3, respectively) and 1.2% were Combined Hepatocellular Cholangiocarcinoma. After modification, the sensitivity increased to 79.6% (P < 0.001), while specificity and PPV remained high (96.6% and 98.7%, P > 0.050).ConclusionThe combination of CE US LI-RADS and AFP for diagnosing HCC improved diagnostic sensitivity significantly, while maintaining high PPV and specificity in patients with the solitary liver nodule.Graphical abstract
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