目的: 探讨动态增强核磁共振成像(dynamic contrast-enhanced magnetic resonance imaging, DCE-MRI)定量灌注参数联合血清miR-6861-5p水平检测对原发性肝癌患者预后的预测价值。方法: 回顾性选取2022年1月至2024年1月78例原发性肝癌患者为研究对象,依据病理分期将患者分为Ⅰ～Ⅱ期组(46例)、Ⅲ期组(32例),比较两组及不同预后患者DCE-MRI定量灌注参数[转运常数(transport constant, K^Trans)、速率常数(rate constant,K_ep)、血管外细胞外间隙体积百分比(volume percentage of extracellular space outside blood vessels, V_e)]、血清miR-6861-5p水平并分析各指标与病理分期、患者预后的相关性及联合检测对患者预后的预测价值。结果: Ⅰ～Ⅱ期组K^Trans、K_ep、V_e、miR-6861-5p低于Ⅲ期组(P＜0.05);与预后良好患者相比,预后不良患者K^Trans、K_ep、V_e、miR-6861-5p水平较高(P＜0.05);K^Trans、K_ep、V_e、miR-6861-5p水平与病理分期、患者预后呈正相关(P＜0.05);DCE-MRI定量灌注参数(K^Trans、K_ep、V_e)联合miR-6861-5p预测患者预后的曲线下面积(area under the curve,AUC)为0.929,约登指数为0.812,敏感度为95.24%,特异度为85.96%(P＜0.05)。结论: DCE-MRI定量灌注参数、血清miR-6861-5p水平与原发性肝癌患者病理分期、预后有关,联合检测对患者预后有一定预测价值。

Objective: To investigate the predictive value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative perfusion parameters combined with serum miR-6861-5p level in the prognosis of patients with primary liver cancer. Methods: A total of 78 patients with primary liver cancer from January 2022 to January 2024 were retrospectively selected as the research objects. According to the pathological stage, the patients were divided into stage Ⅰ-Ⅱ group (46 patients) and stage Ⅲ group (32 patients). DCE-MRI quantitative perfusion parameters [transport constant (K^Trans), rate constant (K_ep), volume percentage of extracellular space outside blood vessels (V_e)] and serum miR-6861-5p levels were compared between the two groups and patients with different prognosis. The correlation between each index and pathological stage, prognosis of patients and the predictive value of combined detection for prognosis of patients were analyzed. Results: K^Trans, K_ep, V_e and miR-6861-5p in stage Ⅰ-Ⅱ group were lower than those in stage Ⅲ group (P＜0.05). Compared with patients with good prognosis, patients with poor prognosis had higher levels of K^Trans, K_ep, V_e and miR-6861-5p (P＜0.05). The levels of K^Trans, K_ep, V_e and miR-6861-5 p were positively correlated with pathological stage and prognosis of patients (P＜0.05). The area under the curve (AUC) of DCE-MRI quantitative perfusion parameters (K^Trans, K_ep, V_e) combined with miR-6861-5p in predicting the prognosis of patients was 0.929, the Youden index was 0.812, the sensitivity was 95.24%, and the specificity was 85.96% (P＜0.05). Conclusion: DCE-MRI quantitative perfusion parameters and serum miR-6861-5p levels are related to the pathological stage and prognosis of patients with primary liver cancer. Combined detection has certain predictive value for the prognosis of patients.