血清DCLK1、LTBP2联合经阴道实时剪切波弹性成像对宫颈癌的早期诊断价值  

Early diagnostic value of serum DCLK1,LTBP2 combined with transvaginal real-time shear wave elastography for cervical cancer

作　　者：王君 徐宁 关三丽 乔敏霞 王利娜 张慧 WANG Jun;XU Ning;GUAN San-li;QIAO Min-xia;WANG Li-na;ZHANG Hui(Ultrasound Medical Center,Xi'an People's Hospital/Xi'an Fourth Hospital,Xi'an Shannxi 710004,China)

机构地区：[1]西安市人民医院/西安市第四医院超声医学中心,陕西西安710004

出　　处：《局解手术学杂志》2024年第11期1009-1014,共6页Journal of Regional Anatomy and Operative Surgery

基　　金：西安市科技计划项目[20YXYJ0005(1)]。

摘　　要：目的探讨血清双皮质素样激酶1(DCLK1)、潜在转化生长因子结合蛋白2(LTBP2)联合经阴道实时剪切波弹性成像(SWE)对宫颈癌的早期诊断价值。方法选取2021年8月至2022年12月于本院就诊的宫颈病变患者155例为研究对象,经手术病理确诊宫颈癌患者75例(宫颈癌组)和宫颈上皮内瘤变(CIN)患者80例(CIN组),另取同期于本院体检的无宫颈相关疾病志愿者80例作为对照组。各组受试者均进行血清DCLK1、LTBP2水平检测及经阴道SWE检查。受试者工作特征(ROC)曲线分析血清DCLK1、LTBP2对宫颈癌的诊断价值;采用四格表法分析血清DCLK1、LTBP2联合经阴道SWE对宫颈癌的诊断价值。结果宫颈癌组患者血清DCLK1、LTBP2水平显著高于CIN组及对照组(P<0.05)。与术前相比,宫颈癌患者术后1、3、6个月的血清DCLK1、LTBP2水平逐渐下降,各时间点两两比较差异均有统计学意义(P<0.05)。血清DCLK1、LTBP2诊断宫颈癌的曲线下面积分别为0.868、0.754,敏感度为86.67%、78.67%,特异度为81.25%、60.00%,最佳截断值为1.49 ng/mL、19.02μg/mL。宫颈癌组患者病灶组织的最大弹性模量、平均弹性模量均显著高于CIN组(P<0.05)。血清DCLK1、血清LTBP2、经阴道SWE诊断宫颈癌的阳性率分别为86.67%、78.67%、82.67%,与金标准均具有一致性(Kappa=0.624、0.501、0.673,P<0.001),三项联合诊断宫颈癌的阳性率为97.33%,与金标准的一致性较高(Kappa=0.846,P=0.001);三项联合诊断的敏感度、准确度均显著高于血清DCLK1、血清LTBP2、经阴道SWE单一指标诊断,三项联合诊断的特异度显著高于血清DCLK1、LTBP2单一指标诊断,三项联合的误诊率均显著低于血清DCLK1、LTBP2单一指标诊断,差异均有统计学意义(P<0.05)。结论血清DCLK1、LTBP2联合经阴道SWE在宫颈癌诊断中应用价值较高,可提升诊断的敏感度、准确度,降低误诊率。Objective To investigate the early diagnostic value of serum double cortin-like kinase 1(DCLK1),latent transforming growth factor binding protein 2(LTBP2)combined with transvaginal real-time shear wave elastography(SWE)for cervical cancer.Methods A total of 155 patients with cervical lesions treated in our hospital from August 2021 to December 2022 were selected as the research objects.Seventy-five patients with cervical cancer(the cervical cancer group)and 80 patients with cervical intraepithelial neoplasia(the CIN group)were diagnosed by surgical pathology,another 80 volunteers without cervical related diseases who participated in physical examinations at our hospital during the same period were selected as the control group.All subjects of each groups underwent serum DCLK1 and LTBP2 levels detection and transvaginal SWE examination.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum DCLK1 and LTBP2 for cervical cancer;the diagnostic value of serum DCLK1 and LTBP2 combined with transvaginal SWE for cervical cancer was analyzed by fourfold table analysis.Results The serum levels of DCLK1 and LTBP2 of patients in the cervical cancer group were obviously higher than those in the CIN group and the control group(P<0.05).Compared with before surgery,the serum levels of DCLK1 and LTBP21,3,and 6 months after surgery in cervical cancer patients gradually decreased,and there were statistical differences in pairwise comparisons at each time point(P<0.05).The area under the curve of serum DCLK1 and LTBP2 for diagnosing cervical cancer were 0.868 and 0.754,respectively,with sensitivity of 86.67%and 78.67%,specificity of 81.25%and 60.00%,and optimal cutoff values of 1.49 ng/mL and 19.02μg/mL.The maximum and average elastic modulus of lesion tissue in the cervical cancer group were obviously higher than those in the CIN group(P<0.05).The positive rates of serum DCLK1,serum LTBP2,and transvaginal SWE in the diagnosis of cervical cance were 86.67%,78.67%,and 82.67%,respectively,which w

关 键 词：双皮质素样激酶1 潜在转化生长因子结合蛋白2 经阴道实时剪切波弹性成像 宫颈癌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]