血清GDF15、sB7-H1联合多层螺旋CT灌注成像技术对胃癌患者淋巴结转移的诊断价值  

Diagnostic values of serum GDF15,sB7-H1 combined with multi-slice spiral CT perfusion imaging technology for lymph node metastasis in gastric cancer patients

作　　者：苑乐添 王艺霖 沈子剑 闫呈新 Letian Yuan;Yilin Wang;Zijian Shen;Chengxin Yan(Department of Imaging,Shandong Provincial Hospital,Jinan 250021,China;School of Medical Imaging,Binzhou Medical University,Yantai 264003,China;Department of Imaging,The Second Affiliated Hospital of Shandong First Medical University,Tai'an 271000,China)

机构地区：[1]山东省立医院影像科,济南250021 [2]滨州医学院医学影像学院,山东烟台264003 [3]山东第一医科大学第二附属医院影像科,山东泰安271000

出　　处：《中华消化病与影像杂志（电子版）》2024年第1期62-66,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：山东省自然科学基金面上项目(ZR2021MH216)。

摘　　要：目的探讨血清生长分化因子15(GDF15)、可溶性B7-H1(sB7-H1)联合多层螺旋CT(MSCT)灌注成像技术对胃癌患者发生淋巴结转移的诊断价值。方法选取2021年5月至2023年5月山东省立医院收治的96例胃癌患者作为研究组,根据有无淋巴结转移将研究组患者分为转移组(41例)和未转移组(55例),另选取同期收治的96例胃良性疾病患者作为对照组。Spearman法分析患者血清GDF15、sB7-H1表达水平与MSCT参数的相关性;Logistic回归分析影响胃癌患者发生淋巴结转移的相关因素;受试者工作特征(ROC)曲线分析血清GDF15、sB7-H1及MSCT参数对胃癌患者淋巴结转移的诊断价值。结果三组MSCT参数比较,差异有统计学意义(P<0.05);转移组血清GDF15、sB7-H1表达水平均高于对照组和未转移组(P<0.05);血清GDF15、sB7-H1表达水平与病变区血容量(BV)和出血流量(BF)均呈负相关,与对比剂平均通过时间(MTT)和表面通透性(PS)呈正相关(P<0.05);转移组肿瘤≥2 cm、浸润深度为黏膜下层的患者所占比例显著高于未转移组(P<0.05);肿瘤大小、浸润深度、GDF15及sB7-H1为胃癌患者发生淋巴结转移的危险因素(P<0.05);血清GDF15、sB7-H1及MSCT单独诊断胃癌患者淋巴结转移的曲线下面积(AUC)分别为0.867、0.804、0.740、0.855、0.580及0.655,血清GDF15、sB7-H1联合MSCT检测的AUC为0.965,联合检测优于血清GDF15、sB7-H1及MSCT各自单独检测(Z联合-GDF15=2.788、Z联合-sB7-H1=3.888、Z联合-BV=4.837、Z联合-MTT=3.255、Z联合-BF=6.281、Z联合-PS=5.529,P均<0.05)。结论血清GDF15和sB7-H1表达水平与胃癌患者淋巴结转移的发生密切相关,二者联合MSCT对胃癌患者发生淋巴结转移具有较高的诊断价值。Objective Exploring the diagnostic values of serum growth differentiation factor 15(GDF15),soluble B7-H1(sB7-H1)combined with multi-slice spiral CT(MSCT)perfusion imaging for lymph node metastasis in gastric cancer patients.Methods A total of 96 gastric cancer patients admitted to Shandong Provincial Hospital from May 2021 to May 2023 were selected as the study group.Patients in the study group were divided into a metastatic group(41 cases)and a non metastatic group(55 cases)based on the presence or absence of lymph node metastasis.Additionally,96 patients with benign gastric diseases during the same period were selected as the control group.The Spearman method was used to analyze the correlation between the expression levels of serum GDF15,sB7-H1 and MSCT parameters in patients;Logistic regression analysis was used to analyze the related factors affecting lymph node metastasis in gastric cancer patients;The diagnostic values of serum GDF15,sB7-H1 and MSCT parameters in lymph node metastasis of gastric cancer patients were analyzed using receiver operating characteristic(ROC)curve.Results There was a statistically significant difference in MSCT parameters among three groups(P<0.05);The expression levels of serum GDF15 and sB7-H1 in the metastatic group were higher than those in the control group and non metastatic group(P<0.05);The expression levels of serum GDF15 and sB7-H1 were negatively correlated with the blood volume(BV)and bleeding flow(BF)in the lesion area,and positively correlated with the mean transit time(MTT)and surface permeability(PS)of the contrast agent(P<0.05);The proportions of patients with tumors≥2 cm and infiltration depth in the submucosal layer in the metastatic group were significantly higher than those in the non metastatic group(P<0.05);Tumor size,depth of invasion,GDF15 and sB7-H1 were risk factors for lymph node metastasis in gastric cancer patients(P<0.05);The area under the curve(AUC)of serum GDF15,sB7-H1 and MSCT for diagnosing lymph node metastasis in gastric cancer patients wer

关 键 词：胃癌 生长分化因子15 可溶性B7-H1 多层螺旋CT 淋巴结转移 

分 类 号：R735.2[医药卫生—肿瘤]