Mp-MRI影像学特征、定量参数及血清miR-221对小肝癌预后的预测价值OA

Objective To investigate the clinical significance of multiparametric magnetic resonance imaging(Mp-MRI)imaging characteristics,quantitative parameters,and serum microRNA-221(miR-221)in predicting the prognosis of small hepatocellular carcinoma(HCC).Methods In total,207 patients with small HCC admitted to Jiangyin Hospital Affiliated to Southeast University School of Medicine from January 2019 to January 2023 were prospectively selected as the research subjects.All patients underwent surgical resection.The prognosis was determined by presence of recurrence within 2 years after surgery,and patients were divided into poor prognosis group(n=41)and good prognosis group(n=166).The general information,traditional tumor markers,imaging characteristics of Mp-MRI,quantitative parameters,and miR-221 were compared between the two groups.The relationship between the imaging characteristics,quantitative parameters,and miR-221 of Mp-MRI and the prognosis of small HCC was analyzed using partial correlation coefficient analysis.The receiver operating characteristic(ROC)curve was used to analyze the prognostic value of quantitative parameters of Mp-MRI and miR-221 alone and in combination for predicting the prognosis of small HCC.Results The levels of serum alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),and tumor specific growth factor(TSGF)in the poor prognosis group were higher than those in the good prognosis group(P＜0.01).The levels of miR-221,maximum slope of descent(MSD)and fat fraction(FF),as well as proportions of liver cirrhosis in the poor prognosis group were higher than those in the good prognosis group,while enhancement rate(ER),apparent diffusion coefficient(ADC),maximum ascending slope(MSI),and mean enhancement time(MET)were lower(P＜0.05).There was no significant difference in the imaging characteristics of Mp-MRI plain scan,or the proportions of portal vein tumor thrombus,rapid wash-in and wash-out enhancement,central scar,and capsule between the two groups(P＞0.05).Partial correlation analysis results showed that after controlling for confounding factors such as AFP,CEA,and TSGF,FF,MSD,miR-221,and cirrhosis were positively correlated with the prognosis of small HCC(partial regression coefficients=3.094,2.956,2.540,3.584,P＜0.01),while ER,ADC,MSI,and MET were negatively correlated with the prognosis of small HCC(partial regression coefficients=0.778,0.777,0.834,0.722,P＜0.01).The ROC curve showed that the areas under the curve(AUCs)of FF,MSD,miR-221,ER,ADC,MSI,and MET for predicting the prognosis of small HCC were 0.764,0.774,0.777,0.767,0.762,0.767,and 0.783,respectively,which were higher than those of AFP,CEA,and TSGF(0.739,0.748,and 0.729)(P＜0.001).The AUC of Ml and M2 for predicting the prognosis of small HCC was 0.865(95％CI:0.811,0.909)and 0.946(95％CI:0.906,0.972),with a sensitivity of 85.37％and 82.93％,and a specificity of 77.11％and 96.39％.The Delong test showed that the AUC of M2 for predicting the prognosis of small HCC was higher than that of M1(P＜0.01).Conclusion The Mp-MRI imaging characteristics,quantitative parameters,and serum miR-221 are closely related to the prognosis of small HCC,providing a reference for early clinical prediction of small HCC prognosis and targeted intervention plans.