MRI结合血清ALP、LDH检测在骨肉瘤早期诊断及预后评估的临床价值  

Clinical Value of MRI Combined with Detection of Serum ALP and LDH in Early Diagnosis and Prognosis Assessment of Osteosarcoma

作　　者：李宏波[1] 旦锋 阮文辉[1] 谢鹏[1] 余国勇[1] LI Hong-bo;DAN Feng;RUAN Wen-hui(Department of Osteoarthrosis Traumatology,Hanzhong Central Hospital,Hanzhong 723000,Shaanxi Province,China)

机构地区：[1]汉中市中心医院骨关节创伤科,陕西汉中723000

出　　处：《中国CT和MRI杂志》2018年第12期133-135,共3页Chinese Journal of CT and MRI

基　　金：陕西省卫生计生科研基金项目(2016C005)

摘　　要：目的分析磁共振成像(Magnetic ResonanceImaging,MRI)结合血清碱性磷酸酶(alkalinephosphatase,ALP)、乳酸脱氢酶(lacticdehydrogenase,LDH)检测在骨肉瘤早期诊断及预后评估的临床价值。方法选取2012年1月-2013年2月我院收治的疑似早期骨肉瘤患者70例纳入研究,均行MRI诊断与血清ALP、LDH检测,以手术病理结果为"金标准",比较MRI、血清ALP与LDH、MRI结合血清ALP与LDH各自的诊断灵敏度、特异度、准确性,并将确诊为骨肉瘤患者依据治疗前血清ALP、LDH水平差异分为高表达组与正常组,比较2组5年生存率。结果 MRI诊断灵敏度83.87%,特异度75.00%,准确性82.86%,Kappa值为0.41;血清ALP与LDH检测灵敏度79.03%,特异度87.50%,准确性80.00%,Kappa值为0.40;MRI结合血清ALP、LDH检测灵敏度95.16%,特异度87.50%,准确性94.29%,Kappa值为0.75;MRI结合血清ALP、LDH检查灵敏度、准确性均明显高于MRI、血清ALP与LDH检查方式(P<0.05);血清ALP与LDH正常表达组5年生存率明显高于高表达组(P<0.05)。结论 MRI结合血清ALP、LDH对骨肉瘤早期诊断具有较高准确性,血清ALP、LDH水平检测能为患者预后评估提供重要依据。Objective To analyze the clinical value of magnetic resonance imaging(MRI)combined with detection of serum alkaline phosphatase(ALP)and lactic dehydrogenase(LDH)in early diagnosis and prognosis assessment of osteosarcoma.Methods A total of seventy patients with suspected early osteosarcoma who were admitted to the hospital from January 2012 to February 2013 were enrolled in the study.All patients underwent MRI scan and detection of serum ALP and LDH.With surgical pathological results as the golden standard,the diagnostic sensitivity,specificity and accuracy rates of MRI,serum ALP and LDH,and MRI combined with serum ALP and LDH were compared.Patients with osteosarcomas were divided into the high expression group and the normal group according to serum ALP and LDH levels,and the 5-year survival rate was compared between the two groups.Results The diagnostic sensitivity,specificity,accuracy and Kappa value of MRI were 83.87%,75.00%,82.86%and 0.41.Those of serum ALP and LDH were 79.03%,87.50%,80.00%and 0.40.Those of MRI combined with serum ALP and LDH were 95.16%,87.50%,94.29%and 0.75.The sensitivity and accuracy of MRI combined with serum ALP and LDH were significantly higher than those of MRI or serum ALP and LDH(P<0.05).The 5-year survival rate of the normal expression group was significantly higher than that of the high expression group(P<0.05).ConclusionMRI combined with serum ALP and LDH is with high accuracy in early diagnosis of osteosarcoma.Serum ALP and LDH levels can provide important evidence for evaluation of the prognosis.

关 键 词：磁共振成像 碱性磷酸酶 乳酸脱氢酶 骨肉瘤 预后 

分 类 号：R445[医药卫生—影像医学与核医学] R73[医药卫生—诊断学]