Abstract:

Objective　To explore the effectiveness and accuracy of magnetic resonance imaging (MRI) multimodal parameters combined with microRNA-21 (miR-21) and long non-coding RNA (lncRNA) FER1L4 in differentiating hepatocellular carcinoma (HCC) from focal nodular hyperplasia (FNH). Methods　Seventy-eight patients treated at Yulin First Hospital from January 2014 to December 2022 were selected as the study objects, including 50 cases of HCC and 28 cases of FNH. There were 29 males and 21 females in the HCC group; they were (59.03±13.12) years old, with a disease course of (2.12±1.43) years. There were 16 males and 12 females in the FNH group; they were (31.48±9.29) years old, with a disease course of (2.27±1.39) years. The MRI multimodal parameters [persistent enhancement, rapid in and out, signal intensity (SI)_{enhancement ratio}, standardized apparent diffusion coefficient (SI_ADC), peritumoral low signal halo, contrast filling defect, linear low signal separation, and central stellate scar] and levels of miR-21 and lncRNA FER1L4 in the lesion tissues were compared between the two groups. The diagnostic efficacies of MRI, miR-21, and lncRNA FER1L4 were assessed by the receiver operating characteristic curves (ROC). t and χ² tests were used. Results　There were no statistical differences in the enhancement patterns and SI_{enhancement rate} between the two groups (χ²=3.640; t=0.207; both P>0.05). However, the SI_ADC in the FNH group was higher than that in the HCC group (t=7.906; P<0.05). There were statistical differences in the morphological features (peritumoral low signal halo, contrast filling defect, linear low signal separation, and central stellate scar) during the hepatobiliary phase between the two groups (χ²=17.160, 17.814, 21.840, and 13.868; all P<0.05). The miR-21 expression in the HCC tissue was higher than that in the FNH tissue, whereas the FER1L4 expression in the HCC tissue was lower than that in the FNH tissue (both P<0.05). When combining MRI, miR-21, and lncRNA FER1L4, 49 cases of HCC and 27 cases of FHN were correctly identified, with an area under the curve (AUC) of 0.972; the sensitivity and specificity were 98.0% and 96.4%, respectively, with a Youden index of 0.944. Conclusion　The combination of MRI multimodal parameters with miR-21 and lncRNA FER1L4 levels in lesion tissues can effectively distinguish HCC from FNH.

Key words:

Magnetic resonance imaging, Hepatocellular carcinoma, Focal nodular hyperplasia, MiR-21, FER1L4

摘要：

目的　探讨磁共振成像（magnetic resonance imaging，MRI）多模态参数联合微RNA-21（microRNA-21，miR-21）和长链非编码RNA（long non-coding RNA，lncRNA）FER1L4在鉴别肝细胞癌（hepatocellular carcinoma，HCC）与局灶性结节增生（focal nodular hyperplasia，FNH）中的有效性和精度。方法　选取2014年1月至2022年12月榆林市第一医院收治的78例患者为研究对象，其中HCC 50例，男29例，女21例，年龄（59.03±13.12）岁，病程（2.12±1.43）年；FNH 28例，男16例，女12例，年龄（31.48±9.29）岁，病程（2.27±1.39）年。比较两组MRI多模态参数［持续性强化、快进快出、信号强度（signal intensity，SI）_增强率、标准化表观扩散系数（standardized apparent diffusion coefficient，SI_ADC）、瘤周低信号环、对比剂充盈缺损、线状低信号分隔和中央星状瘢痕］以及病变组织中miR-21和lncRNA FER1L4水平。采用受试者操作特征曲线（receiver operating characteristic curve，ROC）评估MRI、miR-21和lncRNA FER1L4的诊断效能。采用t检验、χ²检验。结果　两组强化方式、SI_增强率差异均无统计学意义（χ²=3.640，t=0.207，均P>0.05），但是FNH组SI_ADC高于HCC组（t=7.906，P<0.05）；两组肝胆期形态学特征（瘤周低信号环、对比剂充盈缺损、线状低信号分隔和中央星状瘢痕）比较，差异均有统计学意义（χ²=17.160、17.814、21.840、13.868，均P<0.05）。HCC组织中miR-21表达水平高于FNH组织，而FER1L4表达水平低于FNH组织（均P<0.05）。当MRI、miR-21和lncRNA FER1L4三者联合时，诊断出HCC 49例，FHN 27例，曲线下面积0.972，灵敏度和特异度分别为98.0%和96.4%，约登指数0.944。结论　MRI多模态参数联合病变组织中miR-21和lncRNA FER1L4水平可有效区分HCC和FNH。

关键词:

磁共振成像, 肝细胞癌, 局灶性结节增生, miR-21, FER1L4