objectives：to evaluate the value of preoperative mri features and laboratory indicators in predicting the early response of hepatocellular carcinoma (hcc) to transcatheter arterial chemoembolization (tace) combined with high-intensity focused ultrasound (hifu) treatment and to establish a preoperative prediction model.
methods：a total of 188 patients with 223 tumors who underwent tace/hifu treatment from january 2011 to june 2017 were included. tumors were divided into three groups (< 2cm, 2 - 5cm,> 5cm) and classified as non-complete response (ncr) and complete response (cr) cohorts according to the response evaluation criteria in cancer of the liver (recicl) 2015 revised version. univariate analysis and multivariate logistic regression analysis were used to determine independent predictors, and receiver operating characteristic (roc) curve analysis was performed to assess the diagnostic power of each predictor. the prediction model was derived on the β coefficient of the multivariate regression analysis of the predictors.
方法：纳入2011年1月至2017年6月接受tace/hifu治疗的188例患者(223个肿瘤)。根据2015年修订版肝癌疗效评价标准(recicl)，按肿瘤大小分为< 2cm、2-5cm和> 5cm三组，并归为非完全缓解(ncr)队列和完全缓解(cr)队列。采用单因素分析和多因素logistic回归分析确定独立预测因素，受试者工作特性曲线(roc)曲线分析评估各预测因素的预测能力。预测模型由预测因素的多元回归分析β系数衍生而来。
results：irregular margins in the 2 - 5cm group were closely related to early ncr. irregular margins, arterial peritumoral enhancement and abnormal alpha-fetoprotein (afp) were independent predictors of early ncr in the > 5cm group. the prediction model of this group suggests that irregular margins combined with arterial peritumoral enhancement and abnormal afp combined with irregular margins and arterial peritumoral enhancement predict an increased risk of early ncr.
结果：2-5 cm肿瘤组不规则边缘与早期ncr密切相关。不规则边缘、瘤周动脉增强和异常甲胎蛋白(afp)是> 5 cm肿瘤组早期ncr的独立预测因素。本组预测模型提示不规则边缘合并瘤周动脉增强、异常afp合并不规则边缘及瘤周动脉增强预示着早期ncr风险增加。
conclusion：irregular margins of 2 - 5cm tumors and irregular margins, arterial peritumoral enhancement, and abnormal afp of tumors > 5cm can be applied to predict the early response of hcc to tace/hifu treatment.