| 李晓成,孟宪平,费锋.磁共振弥散加权成像联合血清CYFRA211在直肠癌术前分期诊断中的应用价值[J].中国医药导报,2024,21(4):21-24 |
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| 磁共振弥散加权成像联合血清CYFRA211在直肠癌术前分期诊断中的应用价值 |
| Application value of magnetic resonance imaging-diffusion weighted imaging combined with serum CYFRA211 in preoperative staging diagnosis of rectal cancer |
| 收稿日期： 修订日期：2023-09-05 |
| DOI：10.20047/j.issn1673-7210.2024.04.05 |
| 关键词: 磁共振弥散加权成像 CYFRA211 直肠癌 术前分期 |
| Key Words: |
| 基金项目:江苏省重点研发计划项目（BE2022728） |
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| 摘要:目的 分析磁共振弥散加权成像（MRI-DWI）联合血清CYFRA211在直肠癌术前分期诊断中的应用价值。方法 回顾性分析2020年1月至2023年4月东南大学医学院附属江阴医院收治的124例直肠癌患者的临床资料。以病理结果为金标准，分析MRI-DWI联合血清CYFRA211对直肠癌术前T、N分期的诊断价值。 结果 病理结果显示，124例直肠癌患者中，T1期16例、T2期14例、T3期46例、T4期48例；N0期54例、N1期40例、N2期30例。T4期患者血清CYFRA211高于T1、T2、T3期，T3期患者血清CYFRA211高于T1、T2期，T2期患者血清CYFRA211高于T1期（P＜0.05）。N2期患者血清CYFRA211高于N0、N1期，N1期患者血清CYFRA211高于N0期（P＜0.05）。血清CYFRA211诊断直肠癌术前T1、T2、T3、T4、N0、N1、N2期曲线下面积分别为0.756、0.744、0.805、0.897、0.791、0.813、0.821。MRI-DWI对术前T1、T2、T3、T4期的诊断一致性一般（Kappa=0.452、0.587、0.672、0.720，P＜0.01）；MRI-DWI联合血清CYFRA211对术前T1、T2、T3、T4期的诊断一致性较好（Kappa=0.768、0.785、0.827、0.839，P＜0.01）。MRI-DWI对术前N0、N1、N2期的诊断一致性一般（Kappa=0.473、0.598、0.682，P＜0.01），MRI-DWI联合血清CYFRA211对术前N0、N1、N2期的诊断一致性较好（Kappa=0.795、0.821、0.834，P＜0.01）。 结论 MRI-DWI联合血清CYFRA211在直肠癌术前T、N分期的诊断价值更高。 |
| Abstract:Objective To evaluate the application value of magnetic resonance imaging-diffusion weighted imaging (MRI-DWI) combined with serum CYFRA211 in preoperative staging diagnosis of rectal cancer. Methods The clinical data of 124 patients with rectal cancer admitted to Jiangyin Hospital Affiliated to Southeast University School of Medicine from January 2020 to April 2023 were retrospectively analyzed. Using pathological results as the gold standard, the diagnostic value of MRI-DWI combined with serum CYFRA211 in preoperative T and N stages of rectal cancer was analyzed. Results The pathological results showed that there were 16 cases of stage T1, 14 cases of stage T2, 46 cases of stage T3, and 48 cases of stage T4. There were 54 cases of stage N0, 40 cases of stage N1, and 30 cases of stage N2. Serum CYFRA211 in patients with stage T4 was higher than that with stage T1, T2, and T3; serum CYFRA211 in patients with stage T3 was higher than that with stage T1 and T2, and serum CYFRA211 in patients with stage T2 was higher than that with stage T1 (P＜0.05). Serum CYFRA211 in patients with stage N2 was higher than that with stage N0 and N1, and serum CYFRA211 in patients with stage N1 was higher than that in stage N0 (P＜0.05). The area under the curve of preoperative diagnosis of stage T1, T2, T3, T4, N0, N1, and N2 of rectal cancer by serum CYFRA211 was 0.756, 0.744, 0.805, 0.897, 0.791, 0.813, and 0.821, respectively. MRI-DWI was generally consistent in the preoperative diagnosis of stage T1, T2, T3, and T4 (Kappa=0.452, 0.587, 0.672, 0.720, P＜0.01); MRI-DWI combined with serum CYFRA211 showed good consistency in the preoperative diagnosis of stage T1, T2, T3, and T4 (Kappa=0.768, 0.785, 0.827, 0.839, P＜0.01). MRI-DWI was generally consistent in the preoperative diagnosis of stage N0, N1 and N2 (Kappa=0.473, 0.598, 0.682, P＜0.01). MRI-DWI combined with serum CYFRA211 showed good consistency in preoperative diagnosis of stage N0, N1, and N2 (Kappa=0.795, 0.821, 0.834, P＜0.01). Conclusion MRI-DWI combined with serum CYFRA211 has higher diagnostic value in preoperative stages T and N of rectal cancer. |
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