ObjectiveTo investigate the predictive value of contrast-enhanced ultrasonography (CEUS) combined with the aspartate aminotransferase-to-lymphocyte ratio (ALRI) in predicting the therapeutic efficacy and prognosis of primary liver cancer after transarterial chemoembolization (TACE). MethodsWe included 75 patients with hepatocellular carcinoma (HCC) who underwent TACE in our oncology department between January 2019 and December 2021. The patients' clinical data, preoperative ALRI, and postoperative CEUS results were analyzed. ResultsThe optimal cutoff value of ALRI for predicting residual tumor lesions using digital subtraction angiography (DSA) was 42.50. CEUS had a specificity of 0.92, sensitivity of 0.96, and area under the curve (AUC) of 0.940 for determining residual tumor lesions, while ALRI had a specificity of 0.88, sensitivity of 0.70, and AUC of 0.825. The combination of CEUS and ALRI provided a specificity of 0.92, sensitivity of 0.98, and AUC of 0.985 for determining residual tumor lesions. All patients were followed up continuously after the operation. The optimal cutoff value of ALRI for predicting residual tumor lesions in relation to 3-year survival was 41.50. In terms of 3-year survival prediction, DSA showed a specificity of 0.559, sensitivity of 0.889, and AUC of 0.724, CEUS exhibited a specificity of 0.500, sensitivity of 0.852, and AUC of 0.676, and ALRI had a specificity of 0.618, sensitivity of 0.704, and AUC of 0.611. Combined detection of CEUS and ALRI resulted in a specificity of 0.500, sensitivity of 0.889, and AUC of 0.662 for predicting 3-year survival. Patients with negative DSA results, CEUS-negative patients, and those with ALRI ≤41.5 exhibited significantly better survival outcomes compared to their positive counterparts. ConclusionCEUS combined with ALRI yields a higher predictive value in predicting residual tumor lesions and death in patients with HCC after TACE.
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