动态对比增强磁共振成像联合血清微小RNA-486-5p在胰腺癌诊断及手术可切除性评估的应用  

Application of dynamic contrast-enhanced magnetic resonance imaging combined with serum microRNA-486-5p in the diagnosis of pancreatic cancer and evaluation of surgical resectability

作　　者：于敏[1] 张磊 王培成 周丁华 Yu Min;Zhang Lei;Wang Peicheng;Zhou Dinghua(Department of Imaging,Yantaishan Hospital,Yantai 264001,China;Cardiac Catheterization Room,Yantaishan Hospital,Yantai 264001,China;Department of Hepatobiliary Surgery,PLA Rocket Force Characteristic Medical Center,Beijing 100093,China)

机构地区：[1]烟台市烟台山医院影像科,烟台264001 [2]烟台市烟台山医院心导管室,烟台264001 [3]中国人民解放军火箭军特色医学中心肝胆外科,北京100093

出　　处：《中华实验外科杂志》2024年第6期1287-1290,共4页Chinese Journal of Experimental Surgery

摘　　要：目的探究动态对比增强磁共振成像(DCE-MRI)联合血清微小RNA(miR)-486-5p对胰腺癌诊断及手术可切除性评估价值。方法选取2019年6月至2023年6月烟台市烟台山医院收治136例胰腺占位患者为研究对象,患者均接受DCE-MRI扫描及血清miR-486-5p检测,以手术病理为诊断金标准,以实际手术切除为手术可切除性标准,通过诊断试验四格表评价DCE-MRI、血清miR-486-5p及两者联合对胰腺癌诊断、手术可切除性评估价值,组间比较采用Mann-Whitney U检验和χ2检验。结果136例患者经病理诊断确诊胰腺癌(胰腺癌组)98例,非胰腺癌(良性病变组)38例。胰腺癌组血清miR-486-5p表达为3.48(1.41~7.64),显著高于良性病变组的1.02(0.36~1.58)(Z=3.162,P<0.05)。DCE-MRI联合血清miR-486-5p诊断胰腺癌的敏感度、特异度、准确度、与病理诊断的一致性Kappa值分别为97.95%(96/98)、81.58%(31/38)、93.38%(127/136)、0.829。98例胰腺癌患者中,最终实际行手术切除35例(可切除组),不可切除63例(不可切除组)。可手术组血清miR-486-5p表达为2.05(1.01~3.72),显著低于不可切除组的4.88(2.95~10.01)(Z=3.882,P<0.05)。DCE-MRI联合血清miR-486-5p预测胰腺癌可切除的敏感度、特异度、准确度、与实际手术切除的一致性Kappa值分别为77.14%(27/35)、100.00%(63/63)、91.84%(90/98)、0.813。结论DCE-MRI联合血清miR-486-5p能提高胰腺癌诊断敏感度及准确度,且预测手术可切除性与实际手术切除一致性更高。Objective To explore the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with serum microRNA(miR)-486-5p in the diagnosis of pancreatic cancer and evaluation of surgical resectability.Methods Totally,136 patients with pancreatic space-occupying lesions admitted to Yantaishan Hospital,Yantai City from June 2019 to June 2023 were selected as the study subjects.All patients received DCE-MRI scanning and serum miR-486-5p detection.Surgical pathology was used as the diagnostic gold standard and actual surgical resection was taken as the surgical resectability standard,and the value of DCE-MRI,serum miR-486-5p and the combination of the two in the diagnosis of pancreatic cancer and in the evaluation of surgical resectability was evaluated by diagnostic test fourfold table.Mann-Whitney U test and chi-square test were used for comparison between groups.Results Among 136 patients,98 cases of pancreatic cancer(pancreatic cancer group)and 38 cases of non-pancreatic cancer(benign lesion group)were confirmed by pathological diagnosis.The expression level of serum miR-486-5p in pancreatic cancer group was 3.48(1.41-7.64),which was significantly higher than 1.02(0.36-1.58)in benign lesion group(Z=3.162,P<0.05).The sensitivity,specificity,accuracy and consistency Kappa value with pathological diagnosis in the diagnosis of pancreatic cancer were 97.95%(96/98),81.58%(31/38),93.38%(127/136)and 0.829 of DCE-MRI combined with serum miR-486-5p,respectively.Among 98 patients with pancreatic cancer,35 cases(resectable group)actually underwent surgical resection and 63 cases could not be resected(unresectable group).The expression level of miR-486-5p was 2.05(1.01-3.72)in resectable group,which was significantly lower than 4.88(2.95-10.01)in unresectable group(Z=3.882,P<0.05).The sensitivity,specificity,accuracy and consistency Kappa value with actual surgical resection of DCE-MRI combined with serum miR-486-5p in predicting resectable pancreatic cancer were 77.14%(27/35),100.00%(63/63),91.84%(90/98)and 0.8

关 键 词：胰腺癌 磁共振成像 动态对比增强 微小RNA 术前诊断 

分 类 号：R735.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]