CT灌注成像参数联合血清LOXL4、Caspase-4对原发性肝癌患者TACE术后复发的预测价值OA

Objective:To investigate the predictive value of CT perfusion(CTP)parameters combined with ser-um lysyl oxidase-like 4(LOXL4)and Caspase-4 for recurrence after transarterial chemoembolization(TACE)in pa-tients with primary liver cancer(PLC).Methods:A total of 119 PLC patients who received TACE treatment were se-lected.All patients underwent CTP examination at 1 month after TACE,and indicators including blood flow(BF),blood volume(BV),Hepatic Arterial Perfusion Index(HAI)and portal venous perfusion(PVP)were recorded;ser-um concentrations of LOXL4 and Caspase-4 were measured by ELISA at the same period.Postoperative follow-up was conducted for 12 months,and patients were grouped according to the presence or absence of recurrence.Multiva-riate Logistic regression was used to analyze the influencing factors of recurrence after TACE in PLC patients,and a combined prediction model was established.ROC curve was used to evaluate the predictive efficacy of CTP parame-ters,serum LOXL4,Caspase-4 and the combined model for postoperative recurrence.Results:During the follow-up period,41 cases developed recurrence,and the remaining 78 cases had no recurrence.At 1 month after TACE,the lev-els of BF,BV,HAI and serum LOXL4,Caspase-4 in the recurrence group were higher than those in the non-recur-rence group,while the PVP was lower than that in the non-recurrence group(all P＜0.05).BF,HAI,serum LOXL4 and Caspase-4 were independent influencing factors for recurrence after TACE in PLC patients(all P＜0.05),and the combined prediction model was constructed with these four indicators.The AUC of the combined model for pre-dicting postoperative recurrence was higher than the AUC of BF,HAI,serum LOXL4 and Caspase-4 alone(all P＜0.05).Conclusion:CTP parameters BF and HAI,as well as serum LOXL4 and Caspase-4 are influencing factors for recurrence after TACE in PLC patients,and the model jointly constructed by the four indicators has favorable predic-tive efficacy for recurrence after TACE.