To research the predictive value of contrast-enhanced ultrasound (CEUS), serum alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), γ-glutamyltransferase (GGT) and alkaline phosphatase (ALP) on microvascular invasion (MVI) and recurrence in patients with liver cancer after interventional therapy.

A total of 187 patients with primary liver cancer admitted to Affiliated Hospital of Jining Medical University from May 2021 to May 2023 were selected as the research objects. All patients successfully completed transcatheter arterial chemoembolization treatment in our hospital, and CEUS and serum biochemical indexes were detected one week before operation. The MVI and recurrence were diagnosed by postoperative pathological examination and postoperative follow-up, and the relationship between the imaging characteristics of CEUS, serum AFP, CEA, GGT and ALP levels and postoperative MVI and recurrence was analyzed.

Among 187 patients with liver cancer, 61 cases were confirmed as MVI. The results of univariate analysis showed that the incidence of no or incomplete capsule, rapid regression of portal vein signal and tumor necrosis in MVI group was significantly higher than that in non-MVI group. The levels of serum AFP, CEA, GGT and ALP in MVI group were significantly higher than those in non-MVI group (P<0.05). The results of multivariate Logistic regression analysis showed that no or incomplete capsule, rapid regression of portal vein signal, tumor necrosis, serum AFP≥20 μg/L, CEA≥5 μg/L, GGT≥60 U/L and ALP≥120 U/L were independent risk factors for MVI after interventional therapy (P<0.05). After a one-year follow-up survey, 45 of 187 patients with liver cancer recurred. The results of univariate analysis showed that the incidence of no or incomplete capsule, unsmooth edge, rapid fading of portal vein signal and internal necrosis of tumor in recurrent group were significantly higher than those in non-recurrent group, and the serum AFP, CEA, GGT and ALP levels in recurrent group were significantly higher than those in non-recurrent group (P<0.05). Multivariate Logistic regression analysis showed that no or incomplete capsule, unsmooth edge, rapid fading of portal vein signal, tumor necrosis, serum AFP≥20 μg/L, CEA≥5 μg/L, GGT≥60 U/L and ALP≥120 U/L were independent risk factors for postoperative recurrence (P<0.05).

Liver cancer patients with no or incomplete capsule in CEUS examination, rapid fading of portal vein signal and necrosis of tumor are at higher risk of MVI after operation. Liver cancer patients with no or incomplete capsule, unsmooth edge, rapid fading of portal vein signal and tumor necrosis are more likely to have postoperative recurrence. Specific CEUS imaging features combined with serum AFP, CEA, GGT, ALP and other biochemical markers have certain early predictive value for MVI and recurrence of liver cancer patients after interventional therapy.