血清清蛋白与免疫球蛋白联合MRI对脑膜癌的诊断价值分析  

To Analyze the Diagnostic Value of Serum Albumin and Immunoglobulin Combined with MRI in Meningeal Carcinoma

作　　者：刘鹏 李静波 张艳 师春浩 LIU Peng;LI Jingbo;ZHANG Yan(The Third People's Hospital of Nanyang,Nanyang,473000)

机构地区：[1]河南省南阳市第三人民医院,473000

出　　处：《实用癌症杂志》2025年第2期319-323,共5页The Practical Journal of Cancer

摘　　要：目的 分析血清清蛋白与免疫球蛋白联合MRI对脑膜癌的诊断价值。方法 选取疑似脑膜癌患者100例,经脑脊液细胞学检查确诊为脑膜癌66例(脑膜癌组),非脑膜癌34例(非脑膜癌组)(其中结核性脑膜炎20例,原发性颅内肿瘤13例,其他1例)。比较两组血清清蛋白与免疫球蛋白水平,ROC曲线分析MRI联合血清清蛋白、免疫球蛋白对脑膜癌的诊断价值。结果 脑膜癌组ALB水平低于非脑膜癌组(P<0.05),IgG、IgM高于非脑膜癌组(P<0.05),两组IgA比较,P>0.05;ALB最佳阈值为36.125 g/L,灵敏度为0.735,特异度为0.788;IgG最佳阈值为8.765 g/L,灵敏度为0.803,特异度为0.676;IgM最佳阈值为1.58 g/L,灵敏度为0.652,特异度为0.676;MRI联合血清清蛋白与免疫球蛋白对脑膜癌诊断灵敏度为93.94%(62/66)、阴性预测值为87.50%(28/32),均高于单一诊断指标(P<0.05)。结论 MRI联合血清清蛋白与免疫球蛋白可以显著提高脑膜癌病的诊断灵敏度和阴性预测值,具有很高的临床应用价值。Objective To analyze the diagnostic value of serum albumin and immunoglobulin combined with MRI in meningeal carcinoma.Methods A total of 100 patients with suspected leptomeningeal carcinomatosis were selected,including 66 cases of leptomeningeal cancer(leptomeningeal cancer group)and 34 cases of non-leptomeningeal cancer(non-leptomeningeal cancer group),including 20 cases of tuberculous meningitis,13 cases of primary intracranial tumor and 1 case of others.The levels of serum albumin and immunoglobulin were compared between the 2 groups.The ROC curve was used to analyze the diagnostic value of MRI combined with serum albumin and immunoglobulin for meningeal carcinoma.Results Compared with the non-meningeal cancer group,the meningeal cancer group had a significantly lower level of ALB(P<0.05),significantly higher levels of IgG and IgM(P<0.05),and significantly higher levels of IgA(P>0.05).The optimal threshold of ALB was 36.125 g/L,the sensitivity was 0.735,and the specificity was 0.788.The optimal threshold of IgG was 8.765 g/L,the sensitivity was 0.803,and the specificity was 0.676.The optimal threshold of IgM was 1.58 g/L,the sensitivity was 0.652,and the specificity was 0.676.The sensitivity of MRI combined with serum albumin and immunoglobulin in the diagnosis of meningeal carcinoma was 93.94%(62/66),and the negative predictive value was 87.50%(28/32),which were higher than those of single diagnostic index(P<0.05).Conclusion MRI combined with serum albumin and immunoglobulin can significantly improve the diagnostic sensitivity and negative predictive value of leptomeningeal carcinomatosis and has high clinical application value.

关 键 词：脑膜癌 MRI 清蛋白 免疫球蛋白 诊断 

分 类 号：R739.45[医药卫生—肿瘤]