Differentiation of intrahepatic cholangiocarcinoma from hepatocellular carcinoma in high-risk patients: A predictive model using contrast-enhanced ultrasound.
Differentiation of intrahepatic cholangiocarcinoma from hepatocellular carcinoma in high-risk patients: A predictive model using contrast-enhanced ultrasound.
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高危患者肝内胆管癌与肝细胞癌的鉴别：使用超声造影的预测模型
DOI：
10.3748/wjg.v24.i33.3786
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发表时间：
2018-09-07
影响因子：
4.3
通讯作者：
Wang W
中科院分区：
文献类型：
--
作者：
Chen LD;Ruan SM;Liang JY;Yang Z;Shen SL;Huang Y;Li W;Wang Z;Xie XY;Lu MD;Kuang M;Wang W
目的 开发超声造影（CEUS）预测模型，用于区分高危患者的肝内胆管癌（ICC）和肝细胞癌（HCC）。方法 本回顾性研究包括 2004 年 5 月至 2016 年 7 月期间通过倾向评分匹配选择的连续 88 例 ICC 高危患者和 88 例 HCC 高危患者。患者按 1:1 的比例分为两组，即训练组和验证组。用于诊断 ICC 的 CEUS 评分是根据显着的 CEUS 特征生成的。然后，开发了基于 CEUS 评分的列线图，整合了临床数据。然后验证列线图的性能，并与 CEUS 肝脏成像报告和数据系统 (LI-RADS) 的 LR-M 的性能进行比较。结果 ICC最有用的CEUS特征如下：边缘强化（64.5%）、早期褪色（91.9%）、瘤内静脉（58.1%）、瘤内非强化区边界模糊（64.5%）和明显褪色（61.3%，均P < 0.05）。在验证集中，与 LI-RADS (AUC = 0.742) 相比，区分 ICC 和 HCC 的 CEUS 评分 (AUC = 0.953) 的曲线下面积 (AUC) 有所改善 (P < 0.001)。添加临床数据后，CEUS 评分列线图优于 LI-RADS 列线图（AUC：0.973 vs 0.916，P = 0.036，净重分类改进：0.077，综合判别指数：0.152）。亚组分析表明，与 LI-RADS 相比，CEUS 评分模型在小于 5.0 cm 的肿瘤中显着改善（P < 0.05），但在小于 3.0 cm 的肿瘤中没有改善（P > 0.05）。结论 与 CEUS LI-RADS 相比，用于区分高危患者 ICC 和 HCC 的 CEUS 预测模型具有更好的区分度和临床实用性。
AIM To develop a contrast-enhanced ultrasound (CEUS) predictive model for distinguishing intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC) in high-risk patients. METHODS This retrospective study consisted of 88 consecutive high-risk patients with ICC and 88 high-risk patients with HCC selected by propensity score matching between May 2004 and July 2016. Patients were assigned to two groups, namely, a training set and validation set, at a 1:1 ratio. A CEUS score for diagnosing ICC was generated based on significant CEUS features. Then, a nomogram based on the CEUS score was developed, integrating the clinical data. The performance of the nomogram was then validated and compared with that of the LR-M of the CEUS Liver Imaging Reporting and Data System (LI-RADS). RESULTS The most useful CEUS features for ICC were as follows: rim enhancement (64.5%), early washout (91.9%), intratumoral vein (58.1%), obscure boundary of intratumoral non-enhanced area (64.5%), and marked washout (61.3%, all P < 0.05). In the validation set, the area under the curve (AUC) of the CEUS score (AUC = 0.953) for differentiation between ICC and HCC was improved compared to the LI-RADS (AUC = 0.742) (P < 0.001). When clinical data were added, the CEUS score nomogram was superior to the LI-RADS nomogram (AUC: 0.973 vs 0.916, P = 0.036, Net Reclassification Improvement: 0.077, Integrated Discrimination Index: 0.152). Subgroup analysis demonstrated that the CEUS score model was notably improved compared to the LI-RADS in tumors smaller than 5.0 cm (P < 0.05) but not improved in tumors smaller than 3.0 cm (P > 0.05). CONCLUSION The CEUS predictive model for differentiation between ICC and HCC in high-risk patients had improved discrimination and clinical usefulness compared to the CEUS LI-RADS.
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影响因子：
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作者：
Li, Rui;Zhang, Xiaohang;Yan, Xiao-Chu
通讯作者：
Yan, Xiao-Chu
影响因子：
--
作者：
Lu, Qing;Xue, Li-Yun;Li, Cui-Xian
通讯作者：
Li, Cui-Xian
影响因子：
45.3
作者：
Coutant, Charles;Olivier, Camille;Rouzier, Roman
通讯作者：
Rouzier, Roman
影响因子：
4.1
作者：
Kong, Wen-Tao;Wang, Wen-Ping;Mao, Feng
通讯作者：
Mao, Feng
胆管癌：发病机理，诊断和治疗的进展。
影响因子：
13.5
作者：
Blechacz, Boris;Gores, Gregory J.
通讯作者：
Gores, Gregory J.