血清VEGF联合盆腔MRI在子宫内膜癌术前评估中的价值  

The Preoperative Assessment Value of Serum VEGF and Pelvic MRI in Endometrial Carcinoma

作　　者：邓娟 章蒙蒙 方小玲[1] 章婷婷[1] DENG Juan;ZHANG Meng-meng;FANG Xiao-ling;ZHANG Ting-ting(Department of Obsterics and Gynecology,Central South University,Changsha 410011,Hunan,China)

机构地区：[1]中南大学湘雅二医院妇产科,长沙410011

出　　处：《中国现代手术学杂志》2020年第6期401-406,共6页Chinese Journal of Modern Operative Surgery

基　　金：国家自然科学基金青年基金项目(编号:81801425);湖南省自然科学基金青年基金项目(编号:2018JJ3739)。

摘　　要：目的通过回顾性分析探讨血清VEGF联合盆腔MRI在子宫内膜癌术前评估中的价值。方法收集2016年1月至2020年3月在我院确诊为子宫内膜癌的患者112例,测定血清VEGF水平及行盆腔MRI检查进行术前评估。对数据进行统计学分析并绘制ROC曲线。结果随着手术-病理分期、病理分级的升高,血清VEGF阳性率随之增高(P<0.05);有深肌层浸润、宫颈间质浸润及淋巴结转移的患者,血清VEGF阳性率增高,差异有统计学意义(P<0.05);特殊病理类型(非子宫内膜样腺癌)患者血清VEGF较子宫内膜样腺癌患者阳性率增高,差异有统计学意义(P<0.05);子宫内膜癌患者术前盆腔MRI诊断分期与术后手术-病理分期具有一致性,Kappa值0.445,一致性一般;术前血清VEGF联合盆腔MRI诊断子宫内膜癌患者分期与术后病理-手术分期亦具有一致性,Kappa值0.768,一致性高。盆腔MRI及两者联合诊断子宫内膜癌患者分期的ROC-AUC值分别为0.838和0.910,联合诊断高于单项检测,差异有统计学意义(P<0.001)。结论血清VEGF联合盆腔MRI在子宫内膜癌术前评估中具有一定的价值。Objective To study the value of serum VEGF combined with pelvic MRI in preoperative evaluation of endometrial carcinoma by retrospective analysis.Methods From January 2016 to March 2020,a total of 112 patients with endometrial carcinoma were enrolled in the Second Xiangya Hospital.Serum VEGF level and pelvic MRI were measured for preoperative evaluation.Statistical analysis was performed and the ROC curve was plotted.Results With the surgical-pathological stages and pathological grade increased,the serum VEGF positive rate was increasing and the difference was statistically significant(P<0.05).In the patients with deep myometrial invasion,cervical interstitial infiltration and lymph node metastasis,the positive rate of serum VEGF was higher,and the difference was statistically significant(P<0.05).The positive rate of serum VEGF in patients with special pathological type(non endometrioid adenocarcinoma)was higher than that in patients with endometrioid adenocarcinoma,and the difference was statistically significant(P<0.05).The preoperative pelvic MRI staging for evaluating the endometrial carcinoma was consistent with postoperative surgery-pathological staging,and the Kappa value was 0.445 with the general consistency.Whereas preoperative serum VEGF combined with pelvic MRI for diagnosing the high-risk endometrial carcinoma was consistent with postoperative pathology-surgical staging with the Kappa value of 0.768 in a high agreement.At the same time,the ROC-AUC value of pelvic MRI for diagnosis was 0.838 and combined with VEGF detection was 0.910,the latter was higher than the single method,and the difference was statistically significant(P<0.05).Conclusion Serum VEGF combined with pelvic MRI can play a certain value in preoperative evaluation of endometrial carcinoma.

关 键 词：子宫内膜癌 血清VEGF 盆腔MRI 术前评估 

分 类 号：R737.33[医药卫生—肿瘤]