MRI联合血清细胞因子检测在体检中心乳腺癌诊断中的应用研究

Application of MRI combined with serum cytokine detection in the diagnosis of breast cancer in physical examination center

目的研究分析磁共振成像(MRI)联合血清细胞因子检测在健康管理中心乳腺癌诊断中的应用效果。方法选择该院健康管理中心2007年1月至2021年1月经外科查体或X线检查初步诊断为乳腺病变的患者150例作为研究对象,根据病理检查结果将其分为乳腺癌组(95例)和良性组(55例)。通过MRI检测两组乳腺相关情况,采用电化学发光免疫分析法测定两组血清肿瘤标志物癌胚抗原(CEA)、糖类抗原15-3(CA15-3),利用酶联免疫分析法检测两组血管内皮细胞生长因子(VEGF)。以术后病理结果为金标准,分析MRI诊断的效能,采用受试者工作特征(ROC)曲线分析单独血清指标及血清指标联合MRI诊断乳腺癌的效能。结果经MRI诊断,乳腺癌组以环形强化为主,良性组则以均匀强化为主,两组比较差异有统计学意义(P<0.05);经血清细胞因子检测,乳腺癌组血清CA15-3、CEA、VEGF均显著高于良性组,差异有统计学意义(P<0.05);以病理结果为金标准,MRI诊断乳腺癌的灵敏度为92.63%(88/95),特异度为96.36%(53/55),准确率为94.00%(141/150),Kappa值为0.873;ROC曲线分析显示,血清CEA、CA15-3、VEGF诊断乳腺癌的AUC分别为0.741、0.821、0.713,截断值分别为9.52 ng/mL、23.64 U/mL、143.88 pg/mL,3项指标联合MRI诊断AUC为0.994,大于单项血清指标检测(P<0.05)。结论乳腺癌患者拥有显著的MRI动态增强特征,血清因子水平相对较高,通过MRI联合血清细胞因子诊断的灵敏度、确诊准确率更高,值得在临床推广应用。

Objective To study and analyze the application effects of magnetic resonance imaging(MRI)combined with serum cytokine detection in the diagnosis of breast cancer in Health Management Center.Methods A total of 150 patients who were initially diagnosed with breast lesions by surgical physical examination or X-ray examination in Health Management Center of the hospital from January 2007 to January 2021 were selected as the research subjects.According to the results of pathological examination,they were divided into the breast cancer group(95 cases)and the benign group(55 cases).The breast-related conditions of the two groups were detected by MRI.Serum tumor markers of carcinoembryonic antigen(CEA)and carbohydrate antigen 15-3(CA15-3)in the two groups were measured by electrochemiluminescence immunoassay,and vascular endothelial growth factor(VEGF)was detected by enzyme-linked immunosorbent assay.Taking postoperative pathological results as the gold standard,the diagnostic efficiency of MRI was analyzed,and receiver operating characteristic(ROC)curve was used to analyze the efficiency of serum indicators alone and serum indicators combined with MRI in the diagnosis of breast cancer.Results According to MRI diagnosis,the breast cancer group was mainly with annular enhancement,while the benign group was mainly with uniform enhancement,and the differences were statistically significant(P<0.05).The detection of serum cytokines showed that the levels of serum CA15-3,CEA and VEGF in the breast cancer group were significantly higher than those in the benign group,and the differences were statistically significant(P<0.05).Taking the pathological results as the gold standard,the sensitivity,specificity,accuracy rate and Kappa value of MRI in diagnosing breast cancer were 92.63%(88/95),96.36%(53/55),94.00%(141/150)and 0.873.ROC curve analysis revealed that the AUC of serum CEA,CA15-3 and VEGF in the diagnosis of breast cancer were 0.741,0.821 and 0.713 respectively,and their cut off values were 9.52 ng/mL,23.64 U/mL and 143.88 pg/mL,and the AUC of the three indicators combined with MRI was 0.994,which was greater than a single one of serum index detection(P<0.05).Conclusion Patients with breast cancer have significant MRI dynamic enhancement characteristics and relatively high levels of serum cytokines.MRI combined with serum cytokines has higher sensitivity and diagnostic accuracy rate,and it is worthy of clinical promotion and application.