【摘要】 目的探讨低剂量超声造影联合血清微小RNA-106b(microRNA-106b,miR-106b)在肝脏良、恶性占位性病变诊断中的价值。方法对2017年2月至2019年10月在乐山市人民医院治疗的肝脏占位性病变患者120例进行回顾性分析,根据患者的病理结果分为良性病变组(57例)和恶性病变组(63例)。所有患者均给予低剂量超声造影检查,并采用实时荧光定量聚合酶链式反应检测血清miR-106b的相对表达量。采用受试者工作特征(receiver operator characteristic,ROC)曲线分析低剂量超声造影联合血清miR-106b对肝脏良、恶性病变的鉴别价值。结果恶性病变组患者血清miR-106b相对表达量为2.01±0.72,显著高于良性病变组的1.06±0.41,差异有统计学意义(t=8.988,P <0.001)。恶性病变患者超声造影特征中早增强[89.47%(51/57)vs 19.05%(12/63)]、高增强[70.18%(40/57)vs 33.33%(21/63)]和快消退[73.68%(42/57)vs6.35%(4/63)]比例均显著高于良性病变组(χ~2=59.518、16.252、57.397,P均<0.001)。低剂量超声造影联合血清miR-106b鉴别诊断肝脏良、恶性病变的ROC曲线下面积为0.959,显著高于血清miR-106b及低剂量超声造影的0.868、0.877(z=7.495、7.115,P均<0.001)。结论低剂量超声造影联合血清miR-106b水平在肝脏良、恶性占位性病变的诊断中有较好的应用价值。更多还原

【Abstract】 Objective To investigate the value of low-dose contrast-enhanced ultrasound combined with serum microRNA-106b(miR-106b) on identifying benign and malignant spaceoccupying lesions in liver. Methods A total of 120 patients with space-occupying lesions in liver in Leshan People’s Hospital from February 2017 to October 2019 were retrospectively analyzed. The patients were divided into malignant lesion group(57 cases) and benign lesion group(63 cases) according to the pathological results. All patients were given low-dose contrast-enhanced ultrasound and serum miR-106b was detected by real-time fluorescence quantitative polymerase chain reaction. Receiver operator characteristic(ROC) curve was used to analyze the identification value of low-dose contrast-enhanced ultrasound combined with serum miR-106b on benign and malignant space-occupying lesions in liver. Results The miR-106b relative expression of patients in malignant lesion group was 2.01 ± 0.72, which was significantly higher than that in benign lesion group(1.06 ± 0.41), the difference was statistically significant(t = 8.988, P < 0.001). The proportion of early enhancement [89.47%(51/57) vs 19.05%(12/63)], high enhancement [70.18%(40/57) vs 33.33%(21/63)] and fast regression [73.68%(42/57) vs 6.35%(4/63)] of patients in malignant lesions group were significantly higher than those in benign lesions group(χ~2 = 59.518, 16.252, 57.397, all P < 0.001). The area under the ROC curve of low-dose contrast-enhanced ultrasound combined with serum miR-106b in the differential diagnosis of liver benign and malignant lesions was 0.959, which was significantly higher than those of miR-106b(0.877) and low-dose contrastenhanced ultrasound(0.868), the differences were statistically significant(z = 7.495, 7.115, all P < 0.001). Conclusions Low-dose contrast-enhanced ultrasound combined with serum miR-106b level has good application value on the diagnosis of benign and malignant spaceoccupying lesions in liver.更多还原