关键词: 多层螺旋CT, miR-574-5p, miR-876-5p, 原发性肝癌, 诊断

Abstract: Objective To explore the clinical diagnostic value of multi-slice spiral CT combined with serum miR-574-5p and miR-876-5p for primary liver cancer, and analyze the levels of the two factors in the serum of primary liver cancer patients. Methods From June 2023 to June 2024, 120 patients with primary liver cancer admitted to Tieling Central Hospital Affiliated to China Medical University were included as the liver cancer group. During the same period, 60 patients with benign liver lesions were included in the benign liver disease group; 60 healthy individuals who underwent physical examinations in our hospital were classified as the healthy group. Serum samples and clinical data were collected from the research subjects . Multi-slice spiral CT scan was performed. The quantitative polymerase chain reaction (qPCR) method was applied to detect serum miR-574-5p and miR-876-5p. The influencing factors of primary liver cancer were analyzed using logistic regression. ROC curve was applied to analyze and evaluate the diagnostic value of individual and combined detection of various indicators for primary liver cancer. Results The blood flow, hepatic artery perfusion, and average transit time in the liver cancer group were increased compared to the healthy group and the benign liver disease group, while the arrival time of the contrast agent was reduced compared to the healthy group and the benign liver disease group (P<0.05). The serum miR-574-5p level in the liver cancer group was higher than that in other groups, with liver cancer group(3.89±1.03)>benign liver disease group(2.09±0.60)>healthy group(1.03±0.32)(F=277.433,P<0.001), while the miR-876-5p level decreased, with the liver cancer group(0.51±0.14)<benign liver disease group(0.72±0.23)<healthy group(0.98±0.22)(F=127.840,P<0.001), and both pairwise comparisons were meaningful, with obvious differences (P<0.05). The differentiation degree, TNM stage, hepatitis B surface antigen and vascular invasion were different in patients with primary liver cancer (P<0.05). Low differentiation, TNM stage III, positive hepatitis B surface antigen, vascular invasion, large blood flow, long average transit time, and high level of miR-574-5p(OR_miR-574-5p=1.307,P_miR-574-5p=0.001) were risk factors for primary liver cancer, and high level of miR-876-5p(OR_miR-876-5p=0.547,P_miR-876-5p<0.001) was a protective factor for primary liver cancer. The AUC for combined diagnosis was 0.923, with sensitivity and specificity of 86.67% and 81.67%, respectively. The combined diagnosis was superior to individual diagnosis (Z_{combination-blood flow}=2.896, Z combination - average transit time=2.425, Z_{combination-miR-574-5p}=2.910, Z_{combination-miR-876-5p}=4.958, P<0.05). Conclusion Serum miR-574-5p level is elevated in patients with primary liver cancer, while miR-876-5p level is decreased. The combination of multi-slice spiral CT and serum levels of miR-574-5p and miR-876-5p is of great significance and value for the clinical diagnosis of primary liver cancer patients.

Key words: Multi-slice spiral CT, miR-574-5p, miR-876-5p, Primary liver cancer, Diagnosis