MRI动态增强成像联合血清PAI-1、CA27-29对乳腺癌的诊断价值  

Diagnostic Value of Dynamic Contrast-Enhanced MRI Combined with Serum PAI-1 and CA27-29 in Breast Cancer

作　　者：赵洪静 张东坡[1] 杨晓琳 张璐[1] 郑作锋[1] 毛磊[1] 梁枫[1] ZHAO Hong-jing;ZHANG Dong-po;YANG Xiao-lin;ZHANG Lu;ZHENG Zuo-feng;MAO Lei;LIANG Feng(Department of Medical Imaging,Beijing Chuiyangliu Hospital,Beijing 100022,China)

机构地区：[1]北京市垂杨柳医院医学影像科,北京100022

出　　处：《中国CT和MRI杂志》2022年第11期92-95,共4页Chinese Journal of CT and MRI

摘　　要：目的探究MRI动态增强成像(DEC-MRI)联合血清纤溶酶原激活物抑制剂-1(PAI-1)、CA27-29对乳腺癌的诊断价值。方法选取2019年1月至2020年2月于本院乳腺外科就诊的乳腺癌患者90例作为研究对象,另选取年龄相当的同期来本院就诊的乳腺良性肿瘤患者50例作为良性组,所有患者均行DECMRI检查,酶联免疫吸附法(ELISA)检测受试者血清PAI-1、CA27-29水平,受试者工作特征曲线(ROC)分析血清PAI-1、CA27-29水平对乳腺癌的预测价值;Kappa检验分析DEC-MRI及血清PAI-1、CA27-29对乳腺癌诊断结果与病理诊断的一致性;比较DEC-MRI及血清PAI-1、CA27-29与乳腺癌临床病理特征的关系,并分析三者对乳腺癌的诊断价值。结果与良性组相比,乳腺癌组患者病灶DEC-MRI表现为与周围组织分界不清,边缘模糊,强化不均,血清PAI-1、CA27-29水平升高(P﹤0.05);乳腺良性肿瘤病灶表现为与周围组织分界清晰、边缘光滑,强化均匀。ROC分析显示,血清PAI-1、CA27-29预测乳腺癌的截断值分别为25.182 ng/mg、34.373 U/mL。DEC-MRI、血清PAI-1、CA27-29及联合检测诊断乳腺癌结果与病理诊断结果均有中等以上一致性(Kappa=0.799、0.587、0.487、0.835,P﹤0.05)。DEC-MRI及血清PAI-1、CA27-29与肿瘤直径、TNM分期、分类风险及淋巴结转移密切相关(P﹤0.05)。DEC-MRI联合血清PAI-1、CA27-29诊断敏感度显著高于单独诊断(P﹤0.05)。结论血清PAI-1、CA27-29水平升高可能与乳腺癌有关,DEC-MRI扫描联合血清PAI-1、CA27-29可提高乳腺癌诊断灵敏度和准确度,对乳腺癌具有较高预测价值。Objective To explore the diagnostic value of dynamic contrast-enhanced MRI(DEC-MRI)combined with serum plasminogen activator inhibitor-1(PAI-1)and CA27-29 in breast cancer.Methods Ninety cases of breast cancer patients in our hospital from January 2019 to February 2020 were selected as the research objects,another 50 patients with breast benign tumor who came to our hospital at the same time were selected as the benign group,all patients underwent DEC-MRI,the levels of PAI-1 and CA27-29 were detected by enzyme-linked immunosorbent assay(ELISA),the predictive value of serum PAI-1 and CA27-29 levels for breast cancer was analyzed by receiver operating characteristic curve(ROC);Kappa test was used to analyze the consistency of DEC-MRI,PAI-1 and CA27-29 with pathological diagnosis in the diagnosis of breast cancer;the relationship between DEC-MRI,PAI-1,CA27-29 and clinicopathological features of breast cancer was compared,and the diagnostic value of the three in breast cancer was analyzed.Results Compared with those in the benign group,DEC-MRI showed that,the lesions in the breast cancer group showed indistinct boundary with surrounding tissues,blurred edges,uneven enhancement,and the level of serum PAI-1 and CA27-29 were higher(P﹤0.05);benign breast tumors showed clear boundary with surrounding tissue,smooth edge and even enhancement.ROC analysis showed that the cutoff value of serum PAI-1 and CA27-29 was 25.182 ng/mg and 34.373 U/mL,respectively.The results of DEC-MRI,serum PAI-1,CA27-29 and combined detection in the diagnosis of breast cancer had above medium consistency with pathological diagnosis(Kappa=0.799,0.587,0.487,0.835,P﹤0.05).DEC-MRI and serum PAI-1,CA27-29 were closely related to tumor diameter,TNM stage,classification risk and lymph node metastasis(P﹤0.05).The diagnostic sensitivity of DEC-MRI combined with serum PAI-1 and CA27-29 was significantly higher than that of single diagnosis(P﹤0.05).Conclusion The increase of serum PAI-1 and CA27-29 levels may be related to breast cancer.DEC-MRI scann

关 键 词：乳腺癌 磁共振定量动态增强扫描 纤溶酶原激活物抑制剂-1 CA27-29 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]