MR-DWI联合血清miR-190检查在直肠癌新辅助化疗患者预后评估中的应用  

Application of MR-DWI combined with serum miR-190 examination in evaluating the prognosis of patients with after rectal cancer neoadjuvant chemotherapy

作　　者：刘克辉 刘丽杰 符先先[3] 雷小燕 LIU Kehui;LIU Lijie;FU Xianxian;LEI Xiaoyan(Department of Radiology,Haikou Hospital Affiliated to Xiangya School of Medicine,Central South University,Haikou 570000,China;Department of Oncology,The First Affiliated Hospital of Hainan Medical College,Haikou 570102,China;Department of Laboratory Medicine,Hainan Medical College Affiliated to Hainan Medical College,Haikou 570000,China;Department of Radiology,Hainan Medical College Affiliated to Hainan Medical College,Haikou 570003,China)

机构地区：[1]中南大学湘雅医学院附属海口医院放射科,海南海口570000 [2]海南医学院第一附属医院肿瘤科,海南海口570102 [3]中南大学湘雅医学院附属海口医院检验科,海南海口570000 [4]海南医学院附属海南医院放射科,海南海口570003

出　　处：《医学影像学杂志》2023年第4期614-618,共5页Journal of Medical Imaging

基　　金：海南省医药卫生科研项目(编号:1801320114A2003)。

摘　　要：目的探讨磁共振弥散加权成像(MR-DWI)联合血清微小核糖核酸(miR-190)检查在直肠癌新辅助化疗(NAC)患者预后评估中的应用。方法选取133例直肠癌NAC患者,入院时记录患者基线资料,测量MR-DWI表观扩散系数(ADC)值,测定并记录患者血清miRNAs(miR-200a、miR-190)、癌胚抗原(CEA)、糖类抗原(CA)125水平,实施NAC和腹腔镜根治术后随访2年,观察患者预后结局,比较不同预后患者基线资料及治疗前ADC值、血清指标,重点分析MR-DWI联合血清miR-190检查在直肠癌NAC患者预后评估中的应用价值。结果完成NAC和腹腔镜根治术后随访2年发现,133例患者中20例复发,预后不良占15.04%(20/133);经Logistic回归分析检验结果显示,血清miR-190高表达可能是直肠癌NAC患者预后不良的保护因子(OR<1,P<0.05);绘制ROC曲线图,结果显示入院时MR-DWI检查ADC值、血清miR-190水平单独及联合评估直肠癌NAC患者预后的AUC分别为0.843、0.835、0.924,均有一定评估价值,且联合的评估价值更高。结论MR-DWI联合血清miR-190检查在直肠癌NAC患者预后评估中的应用价值较高。Objective To explore the application of magnetic resonance-diffusion weighted imaging(MR-DWI)combined with serum microRNA(miR)-190 in evaluating the prognosis of patients with rectal cancer after neoadjuvant chemotherapy(NAC).Methods 133 patients with rectal cancer after NAC were prospectively selected as research subjects,baseline data of patients were recorded at admission,the apparent diffusion coefficient(ADC)of MR-DWI was measured,serum levels of miRNAs(miR-200a,miR-190),tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen(CA)125 of patients were measured and recorded,NAC and laparoscopic radical operation were performed,the patients were followed up for 2 years,the outcome of prognosis of patients was observed,the baseline data,ADC value and serum indexes of patients with different prognosis were compared,and the application value of MR-DWI combined with serum miR-190 in evaluating prognosis of NAC patients with rectal cancer was mainly analyzed.Results After NAC and laparoscopic radical operation,the patients were followed up for 2 years,among 133 patients included in the study,20 patients recurred and the poor prognosis was 15.04%(20/133);by Logistic regression analysis,the results showed that high expression of serum miR-190 might be a protective factor for poor prognosis of patients with rectal cancer after NAC(OR<1,P<0.05);the ROC curve was drawn,and the results showed that the AUC of ADC value and serum miR-190 level evaluated by MR-DWI at admission in evaluating prognosis in patients with rectal cancer after NAC were 0.843,0.835 and 0.924 respectively,which had certain evaluation value,and the joint evaluation value was higher.Conclusion MR-DWI combined with serum miR-190 has high application value in evaluating the prognosis of patients with rectal cancer after NAC.

关 键 词：直肠癌 新辅助化疗 磁共振成像 微小核糖核酸 

分 类 号：R735.3[医药卫生—肿瘤] R445.2[医药卫生—临床医学]