DWI联合血清SCC-Ag宫颈癌术前预测临床分期及术后3年预后价值  

Efficacy of the apparent diffusion coefficient value of diffusion-weighted magnetic resonance imaging combined with peripheral blood squamous cell carcinoma antigen of women for diagnosing their preoperative clinical staging of cervical cancer and its value for predicting the prognosis of the women within 3 years after surgery

作　　者：巩义春 韩建伟 张海楠 张玉想 温娜 田媛 GONG Yichun;HAN Jianwei;ZHANG Hainan;ZHANG Yuxiang;WEN Na;TIAN Yuan(The Eighth Medical Center,General Hospital of the PLA,Beijing,100091)

机构地区：[1]中国人民解放军总医院第八医学中心,北京100091

出　　处：《中国计划生育学杂志》2024年第9期2170-2176,F0003,共8页Chinese Journal of Family Planning

摘　　要：目的:评价扩散加权磁共振成像(DWI)联合外周血鳞状细胞癌抗原(SCC-Ag)诊断宫颈癌术前临床分期的效能及预测预后价值。方法:回顾性收集2016年9月-2021年3月本院收治的150例宫颈癌和20例健康体检者(健康组)为研究对象,均接受盆腔DWI检查及外周血SCC-Ag水平检测,宫颈癌患者均接受手术治疗,记录患者术后3年预后并分为预后良好组及预后不佳组,比较两组宫颈癌瘤灶的DWI表观扩散系数(ADC值)及外周血SCC-Ag水平。采用Kappa检验评估DWI影像宫颈癌术前临床分期与临床病理分期的一致性;采用受试者工作特征(ROC)曲线评价ADC值联合SCC-Ag预测宫颈癌患者术后3年预后价值。结果:宫颈癌患者随宫颈癌分期增高ADC值降低、SCC-Ag水平增高(均P<0.05)。150例患者均接受随访,随访时间2.5~7.1年,随访中位数3.0年,33例(22.0%)预后不佳,其ADC值(0.90±0.24)均低于预后良好患者(1.21±0.21),外周血SCC-Ag(11.07±1.72 ng/ml)高于预后良好患者(7.72±1.43 ng/ml)(均P<0.05)。宫颈癌患者病理及DWI联合外周血SCC-Ag诊断宫颈癌术前临床分期的kappa=0.7790(95%CI 0.7185~0.9655,P=0.000),一致性较好。ROC分析,外周血SCC-Ag及DWI的ADC值评估宫颈癌患者3年预后的曲线下面积分别为0.936±0.021、0.948±0.018,ADC值联合外周血SCC-Ag评估预后的曲线下面积(0.956±0.018)最高。结论:DWI联合外周血SCC-Ag在诊断宫颈癌术前临床分期一致性较好,且预测患者术后3年月预后效能较高。Objective:To investigate the efficacy of diffusion-weighted magnetic resonance imaging(DWI)combined with peripheral blood squamous cell carcinoma antigen(SCC-Ag)of women for diagnosing their preoperative clinical staging of cervical cancer,and to study its value for predicting the prognosis of the women.Methods:150 women with cervical cancer who admitted to the hospital for cervical cancer surgery(in study group)and 20 healthy women undergoing physical examinations(in control group)from September 2016 to March 2021 were selected as the research subjects.All the women in the two groups were given DWI examination and peripheral blood SCC-Ag detection.The women in the study group received surgical treatment.The prognosis of the women with cervical cancer within 3 years after surgery was recorded and were divided into group A(the women with good prognosis)and group B(the women with poor prognosis).The value of apparent diffusion coefficient(ADC)of DWI and the peripheral blood SCC-Ag level of the women were compared between the two groups.Kappa test was used to evaluate the consistency between the preoperative clinical staging by DWI and the clinical pathological staging of cervical cancer of the women.Receiver operating characteristic(ROC)curve was used to evaluate the ADC value of DWI combined with the peripheral blood SCC-Ag level of the women with cervical cancer for predicting their prognosis within 3-years after surgery.Results:The ADC value of the women with cervical cancer had decreased with their staging of cervical cancer increased,and the SCC Ag level of the women with cervical cancer had increased(all P<0.05).150women in the study group were followed for 2.5-7.1years,and the median duration of the follow-up was 3.0years.There were 33(22.0%)cases with poor prognosis.The ADC value(0.90±0.24)of the women with poor prognosis was significantly lower than that(1.21±0.21)of the women with good prognosis.The peripheral blood SCC-Ag level(11.07±1.72ng/ml)of the women with poor prognosis was significantly higher

关 键 词：宫颈癌 磁共振成像 鳞状细胞癌抗原 分期 预后 效能 

分 类 号：R737.33[医药卫生—肿瘤]