DWI-ADC值及循环肿瘤细胞CK20预测结直肠癌术后复发转移的价值  

Value of DWI-ADC and Circulating Tumor Cells CK20 in Predicting Recurrence and Metastasis of Colorectal Cancer after Operation

作　　者：张丽娜 孙召龙[1] 王铁[2] 郭影 孙爱国 ZHANG Li-na;SUN Zhao-long;WANG Tie;GUO Ying;SUN Ai-guo(Department of Imaging,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061000,Hebei Province,China;Department of Gastroenterology,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061000,Hebei Province,China;Department of Interventional,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061000,Hebei Province,China;Department of Imaging,Cangxian Hospital,Cangzhou 061000,Hebei Province,China)

机构地区：[1]河北省沧州中西医结合医院影像科 [2]河北省沧州中西医结合医院胃肠外科 [3]河北省沧州中西医结合医院介入科 [4]河北省沧县医院影像科,河北沧州061000

出　　处：《中国CT和MRI杂志》2024年第11期141-143,共3页Chinese Journal of CT and MRI

基　　金：河北省2020年度医学科学研究课题计划20200618。

摘　　要：目的探讨磁共振扩散加权成像(DWI)表现扩散系数(ADC)值及循环肿瘤细胞CK20预测结直肠癌(CRC)术后复发转移的价值。方法回顾性分析2020年1月至2022年1月在我院接受诊治的共计100例CRC患者的临床资料,所有患者均接受结直肠癌根治术,并对CRC患者术后进行长达2年的随访观察,随访期间根据影像学或病理检查评估患者肿瘤复发转移情况,将复查时发现术后发生复发转移的患者归为复发转移组(n=38),术后未发生复发转移的患者归为未复发转移组(n=62)。比较两组基础资料信息及DWI-ADC值、循环肿瘤细胞CK20表达情况,采用多因素Logistic回归分析CRC术后复发转移的危险因素,绘制ROC曲线评估DWI-ADC值、循环肿瘤细胞CK20预测CRC术后复发转移的效能。结果复发转移组TNM分期为Ⅲ~Ⅳ期患者、分化程度为低分化患者、循环肿瘤细胞CK20阳性患者占比显著高于未复发转移组,DWI-ADC值显著低于未复发转移组(P<0.05);经多因素Logistic回归分析证实,TNM分期为Ⅲ~Ⅳ期、分化程度为低分化、DWI-ADC值降低、循环肿瘤细胞CK20阳性表达是CRC术后复发转移的独立危险因素(P<0.05);经ROC分析证实,DWI-ADC值、循环肿瘤细胞CK20可用于CRC术后复发转移的评估,曲线下面积分别为0.890、0.691,均有P<0.05。结论TNM分期为Ⅲ~Ⅳ期、分化程度为低分化、DWI-ADC值降低、循环肿瘤细胞CK20阳性表达会增加CRC术后复发转移风险,且DWI-ADC值、循环肿瘤细胞CK20对评估CRC术后复发转移具有一定价值,临床上应引起足够重视。Objective To investigate the value of apparent diffusion coefficient(ADC)value of magnetic resonance diffusion-weighted imaging(DWI)and circulating tumor cells CK20 in predicting postoperative recurrence and metastasis of colorectal cancer(CRC).Methods Clinical data of 100 CRC patients treated in our hospital from January 2020 to January 2022 were retrospectively analyzed.All patients received radical resection of colorectal cancer,and CRC patients were followed up for up to 2 years after surgery.During the followup,tumor recurrence and metastasis of patients were assessed according to imaging or pathological examination.Patients with postoperative recurrence and metastasis were classified into the recurrence and metastasis group(n=38),and those without recurrence and metastasis were classified into the nonrecurrence and metastasis group(n=62).Basic data information,DWI-ADC value and CK20 expression in circulating tumor cells were compared between the two groups.Multivariate Logistic regression was used to analyze the risk factors of postoperative recurrence and metastasis of CRC,and ROC curve was drawn to evaluate the efficacy of DWI-ADC value and CK20 in predicting postoperative recurrence and metastasis of CRC.Results In the recurrence and metastasis group,the TNM stage wasⅢ~Ⅳ,the differentiation degree was low,and the proportion of circulating tumor cells CK20 positive patients was significantly higher than that in the non-recurrence and metastasis group.,and the DWI-ADC value was significantly lower than that in the non-recurrence and metastasis group(P<0.05).Multivariate Logistic regression analysis confirmed that TNM stageⅢ~Ⅳ,low differentiation degree,decreased DWI-ADC value and positive expression of CK20 in circulating tumor cells were independent risk factors for postoperative recurrence and metastasis of CRC(P<0.05).ROC analysis confirmed that DWI-ADC value and circulating tumor cell CK20 could be used to evaluate the recurrence and metastasis of CRC after operation,and the area under the curv

关 键 词：结直肠癌 术后复发转移 磁共振扩散加权成像 表现扩散系数 循环肿瘤细胞CK20 

分 类 号：R574.63[医药卫生—消化系统]