多模式MRI联合CA125、CA153、CA199预测乳腺癌术后复发转移的临床价值研究

Clinical Value of Multi-modal MRI Combined with CA125,CA153 and CA199 in Predicting Postoperative Recurrence and Metastasis of Breast Cancer

目的探讨多模式MRI联合血清糖类抗原CA125、CA153、CA199预测乳腺癌术后复发转移的临床价值。方法分析2018年6月至2021年6月在我院行乳腺癌根治术的486例患者临床资料,按术后复发转移情况分为复发转移组(65例)和未复发转移组(421例),比较两组多模式MRI检查相关参数[转移常数(K^(trans))、速率常数(K_(ep))、表观弥散系数(ADC)]以及血清CA125、CA153、CA199水平差异,ROC曲线分析多模式MRI联合血清肿瘤标志物检查对乳腺癌术后复发转移的预测价值。结果与未复发转移组比较,复发转移组绝经情况、肿瘤大小、肿瘤分期差异均有统计学意义(P<0.05);复发转移组K^(trans)、K_(ep)均高于未复发转移组(P<0.05),ADC值低于未复发转移组(P<0.05);复发转移组血清CA125、CA153、CA199水平均高于未复发转移组(P<0.05);ROC结果显示,K^(trans)、K_(ep)、ADC值、血清CA125、CA153、CA199单独诊断乳腺癌术后复发转移的AUC分别为0.768、0.852、0.735、0.914、0.927、0.859(P<0.05),联合诊断的AUC为0.978(P<0.05)。结论多模式MRI联合CA125、CA153、CA199对乳腺癌术后复发转移具有较好的预测价值,值得推广应用。

Objective To explore the clinical value of multi-modal MRI combined with carbohydrate antigen(CA)125,CA153 and CA199 in predicting postoperative recurrence and metastasis of breast cancer.Methods Analyzed the clinical data of486 patients who underwent radical mastectomy in our hospital from June 2018 to June 2021.They were divided into recurrence and metastasis group(65 cases)and in non-recurrence and metastasis group(421 cases)according to postoperative recurrence and metastasis.The related parameters of multi-modal MRI[transfer constant(K^(trans)),rate constant(K_(ep)),apparent diffusion coefficient(ADC)]and serum CA125,CA153 and CA199 levels were compared between the two groups.ROC curve was used to analyze the predictive value of multi-modal MRI combined with serum tumor marker detection on recurrence and metastasis after breast cancer surgery.Results There were statistically significant differences in menopause status,tumor diameter and tumor staging in recurrence and metastasis group compared with those in non-recurrence and metastasis group(P<0.05).K^(trans) and K_(ep) in recurrence and metastasis group were higher than those in non-recurrence and metastasis group(P<0.05)while ADC value was lower than that in non-recurrence and metastasis group(P<0.05).The levels of serum CEA,CA125 and CA153 were higher in recurrence and metastasis group than those in non-recurrence and metastasis group(P<0.05).ROC results showed that the AUCs of K^(trans),K_(ep),ADC value,serum CA125,CA153 and CA199 in the diagnosis of recurrence and metastasis after breast cancer surgery were 0.768,0.852,0.735,0.914,0.927 and 0.859 respectively(P<0.05).The AUC of combined diagnosis was 0.978(P<0.05).Conclusion Multi-modal MRI combined with CA125,CA153 and CA199 has a good predictive value on recurrence and metastasis after breast cancer surgery.