磁共振成像对宫颈癌诊断的灵敏度、特异度分析及CD8分子在宫颈癌中的表达意义

The Effect of Magnetic Resonance Imaging on Sensitivity and Specificity in the Diagnosis of Cervical Cancer and the Expression of CD8 Molecule

目的探讨磁共振成像对宫颈癌诊断的灵敏度、特异度及CD8分子在宫颈癌中的表达意义。方法随机选取疑似宫颈病变患者120例,均接受盆腔MRI检查、手术病理组织检查及CD8分子表达检测。结果120例患者中,病理组织检查宫颈癌104例,非宫颈癌16例;MRI检查宫颈癌100例,非宫颈癌20例。与病理组织检查相比,MRI检查诊断宫颈癌的灵敏度为92.3%(96/104),特异度为75.0%(12/16),准确度为90.0%(108/120),阳性预测值为96.0%(96/100),阴性预测值为60.0%(12/20)。MRI对宫颈癌分期的准确率分别为0%、77.8%、83.3%、55.6%、87.5%、42.9%、33.3%、83.3%、66.7%,其中MRI对宫颈癌ⅡA2期的诊断效能最高。104例宫颈癌患者中,CD8-82例,+13例,++9例,+++0例,其中临床分期Ⅰ+Ⅱ期、分化程度中高分化、无淋巴结转移患者的CD8分子表达阳性率显著高于临床分期Ⅲ+Ⅳ期、分化程度低分化、有淋巴结转移患者(P<0.05)。CINⅠ+Ⅱ组织中CD8分子表达阳性率显著高于CINⅢ+Ⅳ+原位癌(P<0.05)。结论磁共振成像在宫颈癌诊断中灵敏度、特异度较高,CD8分子表达与宫颈癌的临床分期、分化程度、淋巴转移及病理分级相关。

Objective To investigate the effect of magnetic resonance imaging(MRI)on sensitivity,specificity and CD8 expression in the diagnosis of cervical cancer.Methods 120 patients with suspected cervical lesions were randomly selected.All patients underwent pelvic MRI,pathological examination and CD8 expression detection.Results Of the 20 patients,104 were cervical cancer,16 were non-cervical cancer,100 were cervical cancer and 20 were non-cervical cancer.Compared with pathological examination,the sensitivity,specificity and accuracy of MRI in the diagnosis of cervical cancer were 92.3%(96/104),75.0%(12/16)and 90.0%(108/120),respectively.The positive predictive value was 96.0%(96/100)and the negative predictive value was 60.0%(12/20).Accuracy rates of MRI for cervical cancer staging were 0%,77.8%,83.3%,55.6%,87.5%,42.9%,33.3%,83.3%,66.7%.MRI was the most effective in the diagnosis of stageⅡA2 cervical cancer.Among 104 patients with cervical cancer,CD8-82,+13,++9 and+++0 were found.The positive rate of CD8 expression in patients with clinical stageⅠ+Ⅱ,moderately differentiated,highly differentiated and non-lymph node metastasis was significantly higher than that in patients with clinical stageⅢ+Ⅳ.Patients with poorly differentiated lymph node metastasis(P<0.05).The positive rate of CD8 expression in CINⅠ+Ⅱwas significantly higher than that in CINⅢ+Ⅳ+carcinoma in situ(P<0.05).Conclusion Magnetic resonance imaging has high sensitivity and specificity in the diagnosis of cervical cancer.The expression of CD8 molecule is related to clinical stage,differentiation degree,lymphatic metastasis and pathological grade.