Chinese Hepatolgy ›› 2025, Vol. 30 ›› Issue (10): 1330-1334.

• Liver Cancer • Previous Articles     Next Articles

The predictive value of microvascular invasion in primary liver cancer using neutrophil gelatinase associated lipocalin expression in combination with microflow imaging before TACE treatment

FENG Yan-mei1, WU Juan2, LUO Yu-jiao3   

  1. 1. Color Ultrasound Room, the Second People's Hospital of Shaanxi Province, Xi′an 710000, China;
    2. Department of Imaging 2, Shaanxi Rehabilitation Hospital, Xi′an 710065, China;
    3. Department of Ultrasound, the First Affiliated Hospital of Air Force Medical University, Xi′an 710032, China
  • Received:2024-09-30 Online:2025-10-31 Published:2025-12-16
  • Contact: WU Juan,Email: 119101962@qq.com

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Abstract: Objective To evaluate the predictive value of neutrophil gelatinase associated lipocalin (NGAL) expression combined with multimodal ultrasound of microflow imaging (MFI) for microvascular invasion (MVI) in primary liver cancer (PLC)before hepatic arterial chemoembolization (TACE) therapy. Methods A total of 86 PLC patients treated with TACE from October 2019 to August 2023 werecollected from the Second People's Hospital of Shaanxi Province. NGAL levels were detected by enzyme-linked immunosorbent assay and MFI multimodal ultrasonographys were performed before treatment. Patients were divided into an occurrence group (n=22) and a non-occurrence group (n=64) according to whether they had MVI or not, and the influencing factors and predictive value of multi-modal ultrasound technique combined with NGAL and MFI for MVI in PLC patients were analyzed. Results 22 of the 86 PLC patients (25.58%) had MVI and grouped as the occurrence group. 54.55% of them was Child-Pugh grade C, 50.00% of them was blood flow grade Ⅲ, 59.09% had unsmooth tumor edge, 72.73% had portal phase hyper-enhancement, and their average NGAL level was (129.63±15.62) kU/L, which were higher than those of 21.88%, 14.06%, 29 69%, 43.75%, and (120.14±6.47) kU/L, respectively, in patients of the non-occurrence group (P<0.05). Logistic regression equation analysis showed that NGAL level [OR=1.108 (95%CI: 1.040~1.179)], Child-Pugh grade C [OR=4.286 (95%CI: 1.534~11.973)], blood flow grade Ⅲ [OR=6.111 (95% CI: 2.048~18.285)], highly enhanced portal phase [OR=3.429 (95% CI: 1.187~9.899)], unsmooth tumor margin [OR=3.421 (95% CI: 1.252~9.345)] were influencing factors for predicting MVI in PLC patients (all P<0.05). Through ROC curve analysis, the sensitivities of NGAL level, blood flow grade Ⅲ, highly enhanced portal phase, unsmooth tumor edge, Child-Pugh grade C and their combination for predicting MVI in PLC patients were 72.70%, 50.00%, 72.70%, 59.10%, 54.50%, and 90.90%, respectively. The specificities were 79.70%, 85.90%, 56.20%, 70.30%, 78.10% and 89.10%, respectively. In addition, the combination of the aboval five items to predict MVI in PLC patients had a higher value (AUC 0.911). Conclusion The expression level of NGAL in combination with multimodal ultrasound technique of MFI has a higher value in predicting MVI in PLC patients before TACE treatment.

Key words: Hepatic arterial chemoembolization, Neutrophil gelatinase-associated apolipoprotein, Microflow imaging, Primary liver cancer, Microvascular invasion