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钆塞酸二钠增强磁共振成像与超声在肝细胞癌筛查中的成本效益分析
A cost-effectiveness analysis of Gd-EOB-DTPA contrast-enhanced magnetic resonance imaging versus ultrasound in hepatocellular carcinoma screening
文章发布日期:2018年08月06日  来源:  作者:陈琪萍,林苏,史震山,等  点击次数:502次  下载次数:45次

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【摘要】:目的比较在肝癌高危人群中采用钆塞酸二钠增强MRI(EMRI)与超声行肝癌筛查的成本效益比。方法应用TreeAge Pro 2011软件建立决策树模型,采用数学模型模拟肝硬化患者每6个月行EMRI或超声筛查的成本与收益,计算不同筛查模式下的成本效益比。结果EMRI组和超声组平均每人每次用于肝癌筛查的成本分别为2050.2元和262.6元,获得效益分别为0.11生命年(YLG)和0.02 YLG。当肝癌发病率为17.8%时,EMRI组与超声组的成本效益比大致相同,每1个YLG的成本大致均为11445元,肝癌发病率越高,EMRI检查成本越低,筛查效果越好。EMRI价格越低,其成本效益比逐渐下降,筛查效果越明显。结论肝癌筛查的成本效益与肝癌发病率及检查价格密切相关。当肝癌风险高于17.8%时,采用EMRI筛查可获得较好的成本效益比。
【Abstract】:ObjectiveTo investigate the cost-effectiveness ratio of Gd-EOB-DTPA contrast-enhanced magnetic resonance imaging (EMRI) versus ultrasound in liver cancer screening for the high-risk population. MethodsThe TreeAge Pro 2011 software was used to establish a decision-tree model. A mathematical model was used to simulate the costs and benefits of EMRI or ultrasound screening every 6 months in patients with liver cirrhosis, and the cost-effectiveness ratios under different screening models were calculated. ResultsThe EMRI group had a mean cost of liver cancer screening of 2050.2 RMB each person each time and mean benefits of 0.11 YLG, while the ultrasound group had a mean cost of 262.6 RMB and mean benefits of 0.02 YLG. When the incidence rate of liver cancer was 17.8%, the EMRI group had a similar cost-effectiveness ratio as the ultrasound group, and the cost of 1 YLG was 11445 RMB; EMRI tended to have a lower cost and a better effect in screening with the increase in the incidence rate of liver cancer. The cost-effectiveness ratio of EMRI gradually decreased with the reduction in its price, and its effect in screening gradually increased with the reduction in price. ConclusionThe cost-effectiveness of liver cancer screening is closely related to the incidence rate of liver cancer and the price of screening. EMRI has a good cost-effectiveness ratio in screening when the risk of liver cancer is higher than 17.8%.
【关键字】:癌, 肝细胞; 磁共振成像; 超声检查; 早期诊断; 费用效益分析
【Key words】:carcinoma, hepatocellular; magnetic resonance imaging; ultrasonography; early diagnosis; cost-benefit analysis
【引证本文】:CHEN QP, LIN S, SHI ZS, et al. A cost-effectiveness analysis of Gd-EOB-DTPA contrast-enhanced magnetic resonance imaging versus ultrasound in hepatocellular carcinoma screening[J]. J Clin Hepatol, 2018, 34(9): 1917-1920. (in Chinese)
陈琪萍, 林苏, 史震山, 等. 钆塞酸二钠增强磁共振成像与超声在肝细胞癌筛查中的成本效益分析[J]. 临床肝胆病杂志, 2018, 34(9): 1917-1920.

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