超声造影与血清miR-1290、miR-1825联合对肝脏良恶性占位性病变的鉴别诊断价值

摘要/Abstract

摘要： 目的探讨超声造影联合血清miR-1290、miR-1825在肝脏良恶性占位性病变鉴别诊断价值。方法回顾性分析2023年1月至2024年5月北京中医药大学东方学院秦皇岛医院(秦皇岛市中医医院)收治的肝脏占位性病变患者120例,根据病理结果分为良性病变组48例和恶性病变组72例。所有患者接受超声造影检查并检测血清miR-1290和miR-1825的表达水平。采用受试者工作特征(ROC)曲线分析各指标的鉴别诊断价值。结果恶性病变组血清miR-1290和miR-1825的水平分别为2.34 ± 0.68和1.89 ± 0.53,均高于良性病变组的1.12 ± 0.37和0.94 ± 0.28(均P<0.05)。恶性病变组超声造影特征的早增强、高增强和快消退比例高于良性病变组[91.67%(66/72)比 20.83%(10/48)、76.39(55/72)比 33.33%(16/48)、79.17%(57/72)比 8.33%(4/48)](均P<0.05),均匀增强比例低于良性病变组[19.44%(14/72)比 50.00%(24/48)](P<0.05)。miR-1290、miR-1825水平及超声造影预测特定疾病的敏感性分别为81.9%、88.9%、95.8%,特异度分别为91.7%、85.4%、89.6%。这些结果显示了不同诊断方法在检测该疾病方面的准确性。当超声造影与miR-1290和miR-1825联合使用时,敏感性和特异度分别提升至98.6%和95.8%,表明联合检测具有更高的预测效能。此外,联合检测的约登指数为0.944,AUC面积为0.983(95%CI:0.959~1.000),显示出极高的一致性和可靠性。结论超声造影联合血清miR-1290和miR-1825在肝脏良恶性占位性病变的鉴别诊断中应用价值较高。尤其是三者联合使用时,显示出更高的预测效能和可靠性。因此,联合检测可作为肝脏占位性病变的重要诊断方法。

关键词: 超声造影, miR-1290, miR-1825, 肝脏良恶性病变, 诊断价值

Abstract: Objective To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with serum miR-1290 and miR-1825 in differentiating benign and malignant liver lesions. Methods A retrospective analysis was conducted on 120 patients with liver lesions treated in Qinhuangdao Traditional Chinese Medicine Hospital from January 2023 to May 2024. Based on pathological results, patients were divided into a benign (48 cases) and a malignant (72 cases) lesion group. All patients underwent CEUS and the expression levels of serum miR-1290 and miR-1825 were measured. The diagnostic value of each indicator was analyzed using receiver operating characteristic (ROC) curves. Results The expression levels of serum miR-1290 and miR-1825 in the malignant lesion group were (2.34 ± 0.68) and (1.89 ± 0.53), respectively, which were higher than those of (1.12 ± 0.37) and (0.94 ± 0.28) in the benign lesion group (both P<0.05). The proportion of early enhancement, high enhancement, and rapid washout in the CEUS characteristics of the malignant lesion group was higher than those of benign lesion group [91.67% (66/72) vs. 20.83% (10/48), 76.39% (55/72) vs. 33.33% (16/48), 79.17% (57/72) vs. 8.33% (4/48)] (all P<0.05), while the proportion of homogeneous enhancement was lower in the malignant lesion group [19.44% (14/72) vs. 50.00% (24/48)] (P<0.05). The sensitivity and specificity of miR-1290, miR-1825, and CEUS in predicting specific diseases were 81.9% and 91.7%, 88.9% and 85.4%, and 95.8% and 89.6%, respectively, demonstrating the accuracy of different diagnostic methods in detecting the disease. When CEUS was combined with miR-1290 and miR-1825, the sensitivity and specificity increased to 98.6% and 95.8%, respectively, indicating that the combined detection has higher predictive efficacy. Additionally, the Youden index for the combined detection was 0.944, and the area under the curve (AUC) was 0.983 (95% CI: 0.959-1.000), showing high consistency and reliability. Conclusion CEUS combined with serum miR-1290 and miR-1825 levels has high application value in differentiating benign and malignant liver lesions. Especially the combination of three of them demonstrate a higher predictive efficacy and reliability. Therefore, a combined detection can serve as an important diagnostic method for focal liver lesions.

Key words: Contrast-enhanced ultrasound, miR-1290, miR-1825, Benign and malignant liver lesions, Diagnostic value

张志博, 李静, 邱婧琪, 王倩, 梁爽, 刘翠翠. 超声造影与血清miR-1290、miR-1825联合对肝脏良恶性占位性病变的鉴别诊断价值[J]. 肝脏, 2025, 30(4): 453-457.

ZHANG Zhi-bo, LI Jing, QIU Jing-qi, WANG Qian, LIANG Shuang, LIU Cui-cui. The diagnostic value of contrast-enhanced ultrasound combined with serum miR-1290 and miR-1825 in differentiating benign and malignant liver lesions[J]. Chinese Hepatolgy, 2025, 30(4): 453-457.

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