弥散加权成像、动态增强磁共振成像及血清肿瘤标志物在宫颈癌诊断和分期中的价值  

Relationship between diffusion-weighted imaging,dynamic enhanced MRI and serum tumor markers in cervical cancer diagnosis and disease progression

作　　者：万柘君 许亚春 WAN Zhejun;XU Yachun(Department of Imaging,Hai'an People's Hospital,Haian,Jiangsu 226600,China)

机构地区：[1]江苏省海安市人民医院影像科,江苏海安226600

出　　处：《转化医学杂志》2024年第9期1503-1507,1512,共6页Translational Medicine Journal

摘　　要：目的 探讨综合磁共振成像(MRI)弥散加权成像(DWI)、动态增强MRI(DCE-MRI)及血清肿瘤标志物在宫颈癌诊断及分期中的价值。方法 本研究应用回顾性研究方案,选取海安市人民医院经病理学明确诊断为宫颈癌的患者80例作为宫颈癌组,因宫颈炎症病变接受相关检查的患者80例作为炎症组。检测2组患者DWI、DCE-MRI参数及手术前血清癌胚抗原(CEA)、糖类抗原199(CA199)、CA153、CA125水平并比较,并按照国际妇产科联盟(FIGO)分期标准进行对比分析。结果 宫颈癌组容积转移常数(K^(trans))、速率常数(K_(ep))及血管外细胞外容积分数(V_(e))值均显著高于宫颈炎症患者(P<0.05),表观扩散系数(ADC)值低于炎症组(P<0.05)。宫颈癌组CEA>5.0 ng/mL、CA199>37.0 U/mL、CA153>25.0 U/mL、CA125>35.0 kU/L患者占比分别为80.00%、72.50%、76.25%、72.50%,均显著高于炎症组(均P<0.05)。80例确诊的宫颈癌患者中,FIGO分期Ⅰ期13例,Ⅱ期40例,Ⅲ期22例,Ⅳ期5例。Ⅲ+Ⅳ期患者K_(ep)、K^(trans)、V_(e)值均显著高于Ⅰ+Ⅱ期患者(P<0.05),ADC值低于Ⅰ+Ⅱ期患者(P<0.05);Ⅲ+Ⅳ期患者CEA>5.0 ng/mL、CA199>37.0 U/mL、CA153>25.0 U/mL、CA125>35.0 kU/L患者占比分别为92.59%、88.89%、92.59%、88.89%,均显著高于Ⅰ+Ⅱ期患者(P<0.05)。结论 手术前,宫颈癌患者DCE-MRI参数K_(ep)、K^(trans)、V_(e)及肿瘤标志物CEA、CA199、CA153、CA125水平显著升高,ADC显著降低,并且与FIGO分期有关,临床可在术前进行综合评估,为患者病情诊断及手术治疗方案提供参考。Objective To explore the value of comprehensive application of magnetic resonance imaging(MRI)diffusion-weighted imaging(DWI),dynamic enhanced MRI(DCE-MRI)and serum tumor markers in the diagnosis of cervical cancer.Methods In this study,80 patients diagnosed with cervical cancer by pathology in the People's Hospital of Haian City were selected as the cervical cancer group and 80 patients who underwent relevant examinations due to cervical inflammatory lesions were selected as the inflammation group.The levels of DWI,DCE-MRI,pre-operative serum carcinoembryonic antigen(CEA),carbohydrate antigen-199(CA199),CA153 and CA125 of the two groups of patients were collected and compared according to different staging standards of the International Federation of Obstetrics and Gynecology(FIGO).Results The values of K_(ep),K^(trans) and V_(e) in the cervical cancer group were significantly higher than those in the cervical inflammation group,and the ADC values were lower than those in the inflammation group(P<0.05).The percentages of CEA>5.0ng/mL,CA199>37.0U/mL,CA153>25.0U/mL,CA125>35.0KU/L in cervical cancer group were 80.00%,72.50%,76.25%,72.50%,respectively,which were significantly higher than those in patients with cervical inflammation(P<0.05).Among the 80 patients diagnosed with cervical cancer,FIGO staging was stageⅠin 13 cases,stageⅡin 40 cases,stageⅢin 22 cases,and stageⅣin 5 cases.K_(ep),K^(trans) and V_(e) values in stageⅢ+Ⅳgroup were significantly higher than those in stageⅠ+Ⅱpatients,and ADC values in stageⅢ+Ⅳgroup were lower than those in stageⅠ+Ⅱpatients.The difference was statistically significant(P<0.05).The CEA levels of cervical cancer patients in stageⅢ+Ⅳgroup were>5.0ng/mL,CA199>37.0U/mL,CA153>25.0U/mL,and CA125>35.0 The proportion of KU/L patients(92.59%,88.89%,92.59%,88.89%,respectively)was significantly higher than that of stageⅠ+Ⅱcervical cancer patients(P<0.05).Conclusion Before surgery,the levels of DWI,DCE-MRI parameters and tumor markers in patients with cervical c

关 键 词：宫颈肿瘤 磁共振加权成像 动态增强磁共振成像 癌胚抗原 糖类抗原199 病理学分期 

分 类 号：R737.330.4[医药卫生—肿瘤]