磁共振动态增强扫描成像联合血清SCCA、HE4对宫颈癌盆腔淋巴结转移的诊断价值分析  

Diagnostic Value Analysis of Dynamic Contrast-Enhanced Magnetic Resonance Imaging Combined with Serum SCCA and HE4 for Pelvic Lymph Node Metastasis of Cervical Cancer

作　　者：高鹏[1] 郭小强 梁春杰 陈友智[1] GAO Peng;GUO Xiaoqiang;LIANG Chunjie;CHEN Youzhi(Beijing Fengtai Hospital,Beijing 100071)

机构地区：[1]北京丰台医院,北京100071

出　　处：《智慧健康》2024年第32期38-41,共4页Smart Healthcare

摘　　要：目的研究磁共振动态增强扫描成像联合血清SCCA、HE4对宫颈癌盆腔淋巴结转移的诊断价值。方法选取2020年1月—2023年1月本院妇科收治的100例经手术治疗的宫颈癌患者为研究对象。入院后依次对患者进行病理检查、磁共振动态增强扫描(DCE-MRI)以及血清鳞状细胞癌抗原(SCCA)、人附睾蛋白4(HE4)检测,对比不同检查方式的检测结果,以此为依据将患者分为参比组(未转移者,n=54)与分析组(已转移者,n=37)。再以病理检查结果作为金标准判定DCE-MRI、血清SCCA和HE4检测以及联合检测的诊断效能。结果两组患者DCE-MRI参数中的Ve对比差异无统计学意义(P>0.05);而两组血清SCCA、HE4及Ktrans、Kep对比存在明显差异,且研究组各项指标水平均高于对照组(P<0.05);DCE-MRI检查可见转移31例、未转移59例;血清SCCA、HE4检测可见转移33例、57例;联合检测可见转移35例、未转移55例;联合检测的诊断效能更高,其次为血清标志物检测,最后为DCE-MRI检测。联合检测的灵敏度为89.19%、特异度为98.11%、阳性预测值为94.29%、阴性预测值为94.55%;对比曲线下面积后可见DCE-MRI参数<血清SCCA、HE4<联合检测,其中联合检测的曲线下面积为0.926、标准错误a为0.028、渐近95%置信区间为0.871~0.980。结论采用DCE-MRI与血清SCCA、HE4联合检测的方式,对于检测宫颈癌患者盆腔淋巴结转移具有显著的诊断价值。Objective To investigate effective value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with HE4 and SCCA indicators in diagnosis of pelvic lymph node metastasis of cervical cancer.Methods With research period from January 2020 to January 2023,research location of gynecology department in our hospital,the paper chose 100 cervical cancer patients with surgical treatment research subjects.After admission,patients were treated with pathological examination of DCE-MRI,serum SCCA,and HE4 testing in sequence.Results of different examination methods were compared,patients were divided into groups on the basis.The reference group(n=54,metastatic patients)and the analysis group(n=37,metastatic patients).With gold standard of pathological examination results,diagnostic effect of DCE-MRI,serum SCCA,HE4 detection,and combined detection was determined.Results There was no significant difference in Ve among DCEMRI parameters between two groups(P>0.05).However,there was difference in serum levels of SCCA,HE4,Ktrans,and Kep,those in the study group were higher than the control group(P<0.05).DCEMRI examination showed 31 cases of metastasis and 59 cases of no metastasis.Serum SCCA and HE4 detection showed metastasis of 33 cases and 57 cases respectively.Combined detection showed 35 cases of metastasis and 55 cases of non metastasis,which had higher diagnostic efficiency,followed by serum biomarker detection and DCE-MRI detection.Based on feedback of diagnostic efficiency of combination detection,sensitivity of combined detection was 89.19%,specificity was 98.11%,positive predictive value was 94.29%,and the negative predictive value was 94.55%.Comparison of area under the curve found,DCE-MRI parameter was less than serum SCCA,and HE4 was less than combined detection.Area under the curve of combined detection was 0.926,standard error a was 0.028,and asymptotic 95%confidence interval was 0.871-0.980.Conclusion DCE-MRI combined with serum SCCA and HE4 can achieve relatively high diagnostic value for detecting

关 键 词：磁共振动态增强扫描成像 血清SCCA HE4 宫颈癌 盆腔淋巴结转移 

分 类 号：R73[医药卫生—肿瘤]