MRI联合血β-HCG鉴别诊断妊娠滋养细胞疾病与病理结果一致性分析  

Consistency of MRI combined with bloodβ-HCG in differential diagnosis of gestational trophoblastic disease and pathological results

作　　者：高宇翔 刘英娜 郭伟 GAO Yu-xiang;LIU Ying-na;GUO Wei(Department of Radiology,Zhengzhou Central Hospital,Zhengzhou 450007,Henan,CHINA)

机构地区：[1]郑州市中心医院放射科,河南郑州450007

出　　处：《海南医学》2024年第18期2661-2665,共5页Hainan Medical Journal

基　　金：河南省高等学校重点科研项目(编号:23B320005)。

摘　　要：目的分析MRI联合血β-绒毛膜促性腺激素(β-HCG)鉴别诊断妊娠滋养细胞疾病(GTD)与病理结果的一致性。方法回顾性分析2021年1月至2023年6月郑州市中心医院收治的89例GTD患者的临床资料,比较不同性质GTD患者MRI表现特征及血清β-HCG水平,以组织病理结果为金标准,采用受试者工作特性(ROC)曲线及卡帕(Kappa)值分析MRI联合血β-HCG检测的鉴别诊断价值及一致性。结果恶性GTD患者的血β-HCG水平为(20384.66±317.00)mU/mL,明显高于良性GTD的(840.66±257.33)mU/mL,差异有统计学意义(P<0.05);MRI联合血β-HCG鉴别诊断恶性GTD的灵敏度、阳性预测值(98.55%、100.00%)明显高于MRI(84.06%、90.00%)和血β-HCG(68.12%、40.00%),两者联合诊断的特异度、阴性预测值(100.00%、95.24%)明显高于血β-HCG(79.66%、26.67%),差异均有统计学意义(P<0.05);绘制ROC曲线显示,MRI联合血β-HCG鉴别诊断GTD的AUC为0.993,大于MRI、血β-HCG的0.870、0.541(P<0.05);MRI联合血β-HCG鉴别诊断GTD与病理结果一致性为94.38%,Kappa值为0.830(95%CI:0.623~1.036)。结论MRI联合血β-HCG水平检测与病理结果存在较高的一致性,其联合检测可显著提高GTD鉴别诊断准确性,有助于临床制定有效治疗方案。Objective To analyze the consistency of magnetic resonance imaging(MRI)combined with bloodβchorionic gonadotropin(βHCG)in differential diagnosis of gestational trophoblastic disease(GTD)and pathological results.Methods A retrospective analysis was conducted on the clinical data of 89 patients with GTD admitted to Zhengzhou Central Hospital from January 2021 to June 2023.The MRI features and serumβHCG levels of patients with different types of GTD were compared.Using histopathological results as the gold standard,the diagnostic value and consistency of MRI combined with serumβHCG testing were analyzed using the receiver operating characteristic(ROC)curve and Kappa value.Results The bloodβHCG level in patients with malignant GTD was(20384.66±317.00)mU/mL,which was significantly higher than(840.66±257.33)mU/mL in patients with benign GTD(P<0.05);the sensitivity and positive predictive value of MRI combined with bloodβHCG for the diagnosis of malignant GTD were 98.55%and 100.00%,which were significantly higher than 84.06%and 90.00%of MRI and 68.12%and 40.00%of bloodβHCG.The specificity and negative predictive value of MRI combined with bloodβHCG were 100.00%and 95.24%,which were significantly higher than 79.66%and 26.67%of bloodβHCG(P<0.05).The ROC curve showed that the AUC of MRI combined with bloodβHCG for the differential diagnosis of GTD was 0.993,which was significantly higher than 0.870 of MRI and 0.541 of bloodβHCG(P<0.05).The consistency of MRI combined with bloodβHCG in differential diagnosis of GTD and pathological results was 94.38%,with a Kappa value of 0.830(95%CI:0.6231.036).Conclusion MRI combined with bloodβHCG level detection has high consistency with pathological results,which can significantly improve the accuracy of differential diagnosis for GTD and is helpful for clinical formulation of effective treatment.

关 键 词：妊娠滋养细胞疾病 磁共振成像 血β-绒毛膜促性腺激素 病理结果 鉴别诊断 一致性 

分 类 号：R714.2[医药卫生—妇产科学]