MRI动态增强成像联合血清程序性细胞死亡因子4对乳腺癌的诊断价值  

Diagnostic Value of Magnetic Resonance Imaging Dynamic Contrast-Enhanced Imaging Combined with Serum Programmed Cell Death 4 in Breast Cancer

作　　者：杜森 赵森[1] 周青[1] 孙亮亮 吴海滨[3] DU Sen;ZHAO Sen;ZHOU Qing;SUN Liangliang;WU Haibin(Department of Medical Imaging,the First Affiliated Hospital of Henan University,Kaifeng 475001,China)

机构地区：[1]河南大学第一附属医院医学影像科,河南开封475001 [2]河南大学第一附属医院检验科,河南开封475001 [3]河南大学第一附属医院乳腺甲状腺外科,河南开封475001

出　　处：《中国医学影像学杂志》2023年第9期927-931,共5页Chinese Journal of Medical Imaging

基　　金：2018年河南省医学科技攻关计划(2018020311)。

摘　　要：目的探讨MRI动态增强成像联合血清程序性细胞死亡因子4(PDCD4)对乳腺癌的诊断价值。资料与方法回顾性收集河南大学第一附属医院2019年12月—2022年5月行MRI动态增强成像的女性乳腺肿块患者188例,最终经病理确诊为乳腺癌96例、乳腺良性肿瘤92例。采用酶联免疫吸附法检测PDCD4水平,采用受试者工作特征曲线分析PDCD4对乳腺癌的诊断价值;分析MRI动态增强成像单独及联合血清PDCD4诊断乳腺癌与病理结果的一致性。结果乳腺癌组血清PDCD4表达水平低于非乳腺癌组(t=11.608,P<0.01)。血清PDCD4表达水平诊断乳腺癌的曲线下面积为0.888(95%CI 0.840~0.937)。MRI动态增强成像单独及联合PDCD4诊断乳腺癌与病理结果的一致性较好(Kappa=0.798、0.883,P<0.01)。MRI动态增强成像联合血清PDCD4诊断乳腺癌的敏感度[97.92%(94/96)]、阴性预测值[97.65%(83/85)]高于MRI动态增强成像[分别为87.50%(84/96)和87.63%(85/97);χ^(2)=7.705、6.403,P均<0.05]、血清PDCD4[分别为77.08%(74/96)和78.85%(82/104);χ^(2)=19.048、14.913,P均<0.05]单独诊断,准确度高于血清PDCD4单独诊断[94.15%(177/188)比82.98%(156/188);χ^(2)=11.580,P=0.001]。结论MRI动态增强成像联合血清PDCD4对早期诊断乳腺癌有较高的价值。Purpose To investigate the diagnostic value of dynamic contrast-enhanced MRI combined with serum programmed cell death 4(PDCD4)expression level in breast cancer.Materials and Methods A total of 188 female breast lump patients who underwent dynamic contrast-enhanced MRI from December 2019 to May 2022 in the First Affiliated Hospital of Henan University were retrospectively selected.Finally,96 cases of breast cancer and 92 cases of benign breast tumors were diagnosed by pathological diagnosis.The expression level of serum PDCD4 was detected by enzyme-linked immunosorbent assay,receiver operating characteristic curve was drawn to analyze the diagnostic value of serum PDCD4 expression level for breast cancer;the consistency of MRI dynamic contrast-enhanced imaging alone,in combination with serum PDCD4 with pathological diagnosis in the diagnosis of breast cancer was analyzed.Results The expression level of serum PDCD4 in breast cancer group was significantly lower than that in non-breast cancer group(t=11.608,P<0.01).The area under the curve of serum PDCD4 expression level in the diagnosis of breast cancer was 0.888(95%CI 0.840-0.937).The concordance between dynamic contrast-enhanced MRI alone or in combination with PDCD4 in the diagnosis of breast cancer and pathological diagnosis was good(Kappa=0.798,0.883,P<0.01).The sensitivity and negative predictive value of MRI dynamic contrast-enhanced imaging combined with serum PDCD4 in the diagnosis of breast cancer[97.92%(94/96)and 97.65%(83/85),respectively]were significantly higher than those of MRI dynamic contrast-enhanced imaging[87.50%(84/96)and 87.63%(85/97),respectively;χ^(2)=7.705,6.403,P<0.05]and serum PDCD4 alone[77.08%(74/96)and 78.85%(82/104),respectively;χ^(2)=19.048,14.913,P<0.05],and the accuracy was significantly higher than that of serum PDCD4 alone[94.15%(177/188)vs.82.98%(156/188);χ^(2)=11.580,P=0.001].Conclusion MRI dynamic contrast-enhanced imaging combined with serum PDCD4 has high clinical value for early diagnosis of breast cancer.

关 键 词：乳腺肿瘤 磁共振成像 图像增强 程序性细胞死亡因子4 诊断 鉴别 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]