乙型肝炎病毒 - 地方性肝癌的非侵袭性诊断标准：肝硬化是

StephenW

Dig Dis. 2018 Jan 19. doi: 10.1159/000486196. [Epub ahead of print]
Non-Invasive Diagnostic Criteria for Hepatocellular Carcinoma in Hepatitis B Virus-Endemic Areas: Is Cirrhosis Indispensable?Huang XW1,2, Liao B3, Huang Y1, Liang JY1, Shan QY1, Shen SL4, Xie XY1, Lu MD1,4, Chen LD1, Wang W1.
Author information
1Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.2Department of Ultrasonography, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China.3Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.4Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

AbstractAIM: To confirm whether cirrhosis is indispensable for the non-invasive diagnostic criteria for hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-endemic areas.
METHODS: Between January 2014 and December 2014, a total of 409 patients with pathologically proven focal liver lesions who underwent contrast-enhanced ultrasound (CEUS) were recruited from our institution. Clinical liver cirrhosis, HBV/HCV infection and HCC-typical vascular pattern of the targeted lesion on CEUS were evaluated. The following 3 criteria were applied to these patients to diagnose HCC: criterion 1, clinical liver cirrhosis and HCC-typical vascular pattern; criterion 2, HBV/HCV infection and HCC-typical vascular pattern; criterion 3, HBV/HCV infection or clinical liver cirrhosis and HCC-typical vascular pattern. Pathological reports were considered the gold standard.
RESULTS: A total of 311 patients had confirmed HCC by pathology. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and area under the ROC curve for criterion 1 were 29.6, 90.8, 44.3, 91.1, 28.9, and 0.60% respectively. For criterion 2, they were 83.3, 74.5, 81.2, 91.2, 58.4, and 0.79%, respectively, and for criterion 3, they were 86.2, 72.5, 82.9, 90.9, 62.3, and 0.79% respectively.
CONCLUSIONS: In HBV-endemic areas, when using the HBV/HCV infection instead of cirrhosis as the precondition of the non-invasive diagnostic criteria for HCC, we should be aware of the potential false positive. Cirrhosis still plays an important role in the non-invasive diagnostic criteria for HCC because of the high specificity.

© 2018 S. Karger AG, Basel.

KEYWORDS: Cirrhosis; Contrast-enhanced ultrasound; Diagnosis; Hepatitis B virus; Hepatocellular carcinoma

PMID:29353268DOI:10.1159/000486196

StephenW

挖掘Dis。 2018 Jan 19。doi：10.1159 / 000486196。 [电子版提前打印]
乙型肝炎病毒 - 地方性肝癌的非侵袭性诊断标准：肝硬化是不可或缺的吗？
黄XW 1,2，廖B3，黄Y1，梁健Y1，单QY1，沉SL4，谢XY1，陆MD1,4，陈LD1，王W1。
作者信息

1
    中山大学附属第一医院超声诊断与介入医学超声科。
2
    中山市中山医院超声科。
3
    中山大学附属第一医院病理科，广州。
4
    中山大学附属第一医院肝胆外科。

抽象
目标：

为了证实乙型肝炎病毒（HBV） - 大流行区域的肝细胞癌（HCC）的无创诊断标准是否是肝硬化不可或缺的。
方法：

2014年1月至2014年12月，共有409名经病理证实的肝脏局灶性病变患者接受了超声造影（CEUS）。评估临床肝硬化，HBV / HCV感染和HCC典型血管病变的目标病变的超声造影。以下3个标准应用于这些患者以诊断HCC：标准1，临床肝硬化和HCC-典型血管模式;标准2，HBV / HCV感染和HCC-典型血管模式;标准3，HBV / HCV感染或临床肝硬化和HCC-典型血管模式。病理报告被认为是金标准。
结果：

共有311例患者经病理证实为HCC。标准1的敏感性，特异性，准确性，阳性预测值，阴性预测值和ROC曲线下面积分别为29.6,90.8,44.3,91.1,28.9和0.60％。标准2分别为83.3％，74.5％，81.2％，91.2％，58.4％和0.79％，标准3分别为86.2％，72.5％，82.9％，90.9％，62.3％和0.79％。
结论：

在HBV流行地区，当使用HBV / HCV感染代替肝硬化作为HCC非侵入性诊断标准的前提时，应该意识到潜在的假阳性。由于特异性高，肝硬化在HCC的无创诊断标准中仍然起着重要的作用。

©2018 S. Karger AG，巴塞尔。
关键词：

肝硬化;对比增强超声;诊断;乙型肝炎病毒;肝细胞癌

结论：
    29353268
DOI：