多层螺旋CT联合血清miR-17检测预测胃癌淋巴结转移风险的效果  

Effect of MSCT combined with serum miR-17 detection in predicting the risk of lymph node metastasis in gastric cancer

作　　者：张海玲 陈丹丹 朱季军 王晓燕 张诗琪 Zhang Hailing;Chen Dandan;Zhu Jijun;Wang Xiaoyan;Zhang Shiqi(Department of Gastroenterology,Jiangsu Province People's Hospital Suqian Hospital,Suqian 223812,China)

机构地区：[1]江苏省人民医院宿迁医院消化内科,223812

出　　处：《中华消化病与影像杂志(电子版)》2025年第1期23-28,共6页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：宿迁市科技计划项目(KY202203)。

摘　　要：目的探究多层螺旋CT(MSCT)联合血清微RNA-17(miR-17)检测预测胃癌淋巴结转移风险的效果。方法回顾性选取2023年1月至2024年2月江苏省人民医院宿迁医院确诊胃癌患者110例为研究对象,根据是否发生淋巴结转移分为转移组(n=47)和未转移组(n=63)。所有患者均行MSCT检查并收集血液样本分离血清,采用实时荧光定量PCR检测血清miR-17水平。比较两组MSCT测量参数[病变区血容量(BV)、对比剂平均通过时间(MTT)、表面通透性(PS)、出血流量(BF)],采用Pearson相关性分析MSCT测量参数与血清miR-17水平的相关性;以病理检查结果为金标准,分别评估MSCT检查、MSCT联合血清miR-17检测在胃癌淋巴结转移诊断中的应用价值。结果两组肿瘤大小、TNM分期、分化程度存在显著差异(均P<0.05)。相比未转移组,转移组的BV、PS均显著降低,而MTT、BF和血清miR-17水平则显著升高(均P<0.001)。Pearson相关性显示,BV(r=-0.361)、PS(r=-0.194)与血清miR-17水平呈显著负相关,MTT(r=0.424)、BF(r=0.250)与血清miR-17水平呈显著正相关(均P<0.05)。MSCT检查结果显示,胃癌淋巴结转移患者43例;未转移患者52例,误诊4例,漏诊11例。MSCT联合血清miR-17检查显示,胃癌淋巴结转移患者45例;未转移患者60例,误诊2例,漏诊3例。MSCT诊断胃癌淋巴结转移:准确率86.36%(85/110),灵敏度91.49%(43/47),特异度82.54%(52/63),阳性预测率79.63%(43/54),阴性预测率92.86%(52/56),与病理检查结果的Cohen's Kappa值为0.727。进一步联合血清miR-17后:准确率95.45%(105/110),灵敏度95.74%(45/47),特异度95.24%(60/63),阳性预测率93.75%(45/48),阴性预测率96.77%(60/62),与病理检查结果的Cohen's Kappa值为0.907。结论MSCT联合血清miR-17检测可显著提高胃癌淋巴结转移风险的预测准确率及诊断效能,与病理诊断一致性高。Objective To investigate the effect of multislice spiral CT(MSCT)combined with serum microRNA-17(miR-17)detection in predicting the risk of lymph node metastasis in gastric cancer.Methods A total of 110 patients diagnosed with gastric cancer in Jiangsu Province People's Hospital Suqian Hospital from January 2023 to February 2024 were retrospectively selected as the study objects,and were divided into metastatic group(n=47)and non-metastatic group(n=63)according to whether lymph node metastasis occurred.All patients underwent MSCT examination and blood samples were collected to isolate serum,and real-time fluorescence quantitative PCR was used to detect serum miR-17 levels.MSCT measurement parameters[blood volume in the lesion area(BV),mean transit time of contrast agent(MTT),surface permeability(PS),and bleeding flow(BF)]were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between MSCT measurement parameters and serum miR-17 level.Using pathological examination results as the gold standard,the application value of MSCT and MSCT combined with serum miR-17 detection in the diagnosis of lymph node metastasis of gastric cancer was evaluated.Results There were statistically significant differences in tumor size,TNM stage and differentiation degree between the two groups(all P<0.05).Compared with the non-metastatic group,BV and PS were significantly decreased in the metastatic group,while MTT,BF and serum miR-17 levels were significantly increased(all P<0.001).Pearson correlation showed that BV(r=-0.361)and PS(r=-0.194)were significantly negatively correlated with serum miR-17 level,while MTT(r=0.424)and BF(r=0.250)were significantly positively correlated with serum miR-17 level(all P<0.05).MSCT examination results showed that 43 patients with gastric cancer lymph node metastasis.There were 52 cases without metastasis,4 cases were misdiagnosed and 11 cases were missed.MSCT combined with serum miR-17 showed 45 cases of gastric cancer with lymph node metastasis.There were

关 键 词：胃癌 淋巴结转移 多层螺旋CT miR-17 诊断 

分 类 号：R735.2[医药卫生—肿瘤]