Preoperative Differential Diagnostic Value of Serum Markers Combined with Conventional Ultrasound and Contrast-Enhanced Ultrasound for Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma
JING Xiaoyun, FENG Shaoyang**, XU Keke
Department of Ultrasound Medicine, the Sixth People's Hospital of Zhengzhou, Zhengzhou Henan 450000
Abstract：【Objective】 To explore the preoperative differential diagnostic value of serum markers combined with conventional ultrasound and contrast-enhanced ultrasound (CEUS) for hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). 【Methods】 A total of 124 patients with hepatocellular carcinoma (HCC group) and 116 patients with intrahepatic cholangiocarcinoma (ICC group) admitted to our hospital from January 2022 to November 2024 were enrolled. The levels of alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and carbohydrate antigen 19-9 (CA19-9) were detected in both groups. All patients underwent conventional ultrasound and CEUS examinations. The serum marker levels, conventional ultrasonic features, CEUS manifestations and quantitative parameters were compared between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the preoperative differential diagnostic efficacy of combined detection for HCC and ICC. 【Results】 The AFP level of the HCC group was higher than that of the ICC group, while the levels of CEA, CA125 and CA19-9 were lower in the HCC group (P<0.05). Statistically significant differences were observed between the two groups in conventional ultrasonic signs including irregular lesion shape, lesion echo, blurred boundary, bile duct dilatation and portal vein tumor thrombus (P<0.05). Significant intergroup differences were also found in CEUS features such as irregular shape, blurred boundary, homogeneous arterial phase enhancement and portal phase enhancement pattern (P<0.05). The arrival time and time to peak of the HCC group were longer than those of the ICC group (P<0.05). ROC curve analysis showed that the sensitivity, specificity and area under the curve (AUC) of combined serum markers, conventional ultrasound and CEUS for preoperative differentiation were 96.0%, 95.7% and 0.974 respectively, which were superior to single indicator detection. 【Conclusions】 The combined application of serum markers, conventional ultrasound and CEUS presents high sensitivity and specificity in the preoperative differentiation of HCC and ICC, which can effectively improve preoperative diagnostic accuracy and provide strong evidence for clinical diagnosis.
2026, Vol. 43 
