The Application Of Transrectal Ultrasound Elastography (TRE) In The Detection Of Hepatocellular Carcinoma

Background Hepatocellular Carcinomaworldwide morbidity and mortality are very high,the incidence and mortality of PHC in China even more than the average level of the world,the life and health of patients is a serious threat,which brings a heavy burden to the patient’s family and society,also a great drain on health resources.The clinical diagnosis of liver cancer is a prerequisite for further treatment.The diagnostic criteria in pathological diagnosis as the gold standard,including liver lesions or extrahepatic metastasis resection of lesions or surgical specimens by pathology and cytology(or)were diagnosed.But because of some special reasons to get organized samples or cytology,solid tumors all currently recognized at home and abroad,only HCC can use clinical diagnostic criteria.Combined with our current situation,the domestic standard and practical application of previous clinical diagnostic criteria,the expert group to develop in the clinic will be limited to a certain extent.For patients with liver cancer.Can discover the malignant lesions and diagnosis of liver tissue determines the treatment and prognosis of patients.Histopathologic examination can accurately observe and judge the liver directly Tissue lesions,malignant degree and pathological type.But as an invasive examination,itself has the limitation of sampling,noninvasive,postoperative complications,and is not easy to accept for patients,making this method in the clinical application are limited;although noninvasive imaging diagnosis,but the complex,so expensive,for a longer period of time,and the lesion size limit,also restricted in clinical application.Early detection,early diagnosis is very important,so to find a new diagnostic method instead of liver biopsy and imaging method is necessary.The liver ultrasound elastography in the diagnosis of hepatic fibrosis in the technology has matured in recent years,with the development of ultrasound elastography,ultrasound elastography has become the focus of clinical research,in thyroid cancer,breast cancer,prostate cancer diagnosis of deep It is preliminarily used in the diagnosis of the above tumors,but the ultrasonic elastography is still a preliminary exploration in the diagnosis of primary liver cancerObjectiveTo investigate the value of ultrasound elastography in the diagnosis of HCCMethodsSelection of eligible patients,diagnosed with primary liver cancer(primary liver cancer diagnosis standard(2011 Edition)and patients with cirrhosis(cirrhosis diagnosed according to clinical diagnosis standards)patients,the amount of application of value determination of Yang Shimo ultrasound elastography diagnosis instrument(elastic value)and recording,analysis and comparison with elastic values with AFP,AST,ALT,albumin,platelet,APRI,FIB4 and other related.(1)compare the size of the young’s modulus between the liver cancer tissue and the paracancerous tissue;(2)AFP was used as an important serological marker for the diagnosis of HCC,and the relationship between AFP and HCC was analyzed;(3)the influence of inflammatory indexes on the young’s modulus of liver cancer tissue;(4)compare the size of Young’s modulus of liver cancer tissue and liver cirrhosis tissue;(5)the DSA patients with HCC were observed to have abundant and relatively poor blood supply in the TACE surgery,and the young’s modulus values of the two liver cancer tissues were compared;(6)predict the ROC curve of primary liver cancer by the young’s modulus value measured by the liver ultrasonic elasticity test.Through the t test or analysis of variance correlation with liver pathological results to determine the initial elastic value will be statistically significant indicators into theLogistic regression model,and then screened with independent predictors of liver biopsy results of the index.Results1 a total of 59 cases of primary liver cancer patients and 45 cases of liver cirrhosis patients completed the ultrasound elastography,determine the lesion elasticity,surrounding tissue elasticity.The average value of the cancer tissue and peripheral tissue of Young’s modulus value were 96.13 + 44.69,19.6 + 13.8,two,the difference was statistically significant;the average value the young’s modulus of liver cancer and cirrhosis tissue values were 93.16 + 44.69,11.01 + 7.07,the difference was statistically significant.2 single factor analysis showed that AFP,albumin,platelet,APRI,FIB4 and other factors on the liver elasticity and hardness measurement results showed no obvious correlation.AST in serum and liver tissue elasticity high correlation,positive correlation.3 through the hepatic artery angiography,the liver cancer group was divided into the rich blood group and the lack of blood supply group,the two groups were compared,the blood supply is rich in the young’s modulus of the tissue was significantly higher than that of the blood supply.4 SR value(the young’s modulus of liver cancer tissue / Young modulus value of surrounding tissue)to predict the ROC curve of HCC.Through the analysis of ROC curve,SR=54.95,the area under the curve is the largest.Conclusions1.The young’s modulus of HCC was significantly higher than the value of Young’s modulus of surrounding tissue and liver cirrhosis group values,under certain conditions,the higher the AST,the young’s modulus of liver tissue larger;alpha fetoprotein,albumin,platelet,alt,APRI,modulus FIB4 and hepatocellular carcinoma had no obvious correlation for the rich blood supply of liver cancer tissue,the young’s modulus is higher.2.The application of TRE has important significance for the diagnosis of HCC,when the cut-off value was 54.95,the sensitivity and specificity of the diagnosis of primary hepatocellular carcinoma has high.Contribute to the diagnosis of primary liver cancer.