The value of perfluorobutyane for injection contrast-enhanced ultrasound combined with serum αL-fucosidase,forkhead box A1 and clusterin in the differentiation of small hepatocellular carcinoma and focal nodular hyperplasia of the liver

Zhou Min; Rong Lu; Yu Luxin; Wan Jing; Lyu Juan

doi:10.3760/j.issn.1673-4777.2024.11.016

Abstract：Objective To explore the value of perfluorobutyane for injection contrast-enhanced ultrasound combined with serum αL-fucosidase(AFU),forkhead box A1(FOXA1)and clusterin in the differentiation of small hepatocellular carcinoma(SHCC)and focal nodular hyperplasia(FNH)of the liver.Methods A total of 264 suspected patients with SHCC or FNH admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from March 2021 to March 2024 were selected and divided into SHCC group(87 cases)and FNH group(177 cases)according to the results of pathological examination.The perfluorobutyane for injection contrast-enhanced ultrasound was used to compare the related parameters.Enzyme-linked immunosorbent assay was used to detect and compare the expression of serum AFU,FOXA1 and clusterin.The receiver operating characteristic curve was drawn to analyze the diagnostic value of serum AFU,FOXA1 and clusterin for SHCC and FNH.The differential value of perfluorobutane for injection contrast-enhanced ultrasound combined with serum AFU,FOXA1 and clusterin in SHCC and FNH was analyzed by four-grid table.Results The proportion of contrast agent arriving earlier than the surrounding area,contrast agent perfusion defect,and enhancement expansion＞10％in arterial phase in the SHCC group were higher than those in the FNH group,and the proportion of high-enhancement rings in Kupffer phase was lower than that in the FNH group(all P＜0.05).The serum levels of AFU,FOXA1 and clusterin in SHCC group were higher than those in FNH group[(64±6)U/L vs(36±5)U/L,(18.4±2.5)μg/L vs(13.3±2.2)μg/L,(120±16)μg/L vs(84±14)μg/L](t=38.944,16.829,18.925,all P＜0.001).The results of receiver operating characteristic curve analysis showed that the area under the curve of serum AFU,FOX A1 and clusterin in the diagnosis of SHCC and FNH were 0.895(95％confidence interval:0.857-0.934),0.900(95％confidence interval:0.861-0.940)and 0.866(95％confidence interval:0.820-0.913),respectively.The area under the curve of the combination of the three markers for the diagnosis of SHCC and FNH was 0.979(95％confidence interval:0.965-0.994).The accuracy of perfluorobutane for injection contrast-enhanced ultrasound in the detection of SHCC and FNH is higher than that of AFU,FOXA1 and clusterin alone,and slightly lower than that of the combined detection of the four.Conclusion Perfluorobutane for injection contrast-enhanced ultrasound combined with serum AFU,FOXA1 and clusterin can improve the differentiation value of SHCC and FNH.