超声联合血清MYCN、Smad7 mRNA检测对神经母细胞瘤的诊断价值

Diagnostic value of ultrasound combined with serum MYCN and Smad7 mRNA detection in neuroblastoma

目的:探讨彩色多普勒超声联合血清MYCN、Smad7 mRNA检测在诊断儿童神经母细胞瘤中的临床价值。方法:选取确诊的48例神经母细胞瘤患儿为神经母细胞瘤组,同期选取因腹胀、腹泻、便秘、呕吐等原因就诊最终排除神经母细胞瘤的患儿50例作为对照组,对其均行彩色多普勒超声检查。采用实时荧光定量PCR(qRT-PCR)法检测血清MYCN mRNA、Smad7 mRNA表达水平。绘制受试者工作特征(ROC)曲线分析血清MYCN mRNA、Smad7 mRNA对神经母细胞瘤的诊断效能,采用一致性Kappa检验分析各诊断方法与手术或穿刺病理结果的一致性。结果:神经母细胞瘤组血清MYCN mRNA、Smad7 mRNA表达水平显著高于对照组(均P<0.05)。血清MYCN mRNA、Smad7 mRNA诊断神经母细胞瘤的曲线下面积(AUC)分别为0.867(95%CI:0.795~0.938)、0.818(95%CI:0.734~0.901),特异度分别为88.00%、84.00%,灵敏度均为75.00%。超声检查结果中假阳性8例,假阴性11例,与手术或穿刺病理结果的一致性较高,Kappa值为0.612(P<0.05);超声联合血清MYCN mRNA、Smad7 mRNA检查结果中假阳性9例,假阴性4例,与手术或穿刺病理结果的一致性较高,Kappa值为0.735(P<0.05)。超声联合血清MYCN mRNA、Smad7 mRNA诊断神经母细胞瘤的灵敏度显著高于三者单独诊断(P<0.05)。结论:超声检查对儿童神经母细胞瘤有较高的诊断价值,其联合血清MYCN mRNA、Smad7 mRNA后诊断价值有一定的提高。

Objective:To investigate the clinical value of color Doppler ultrasonography combined with serum MYCN and Smad7 mRNA detection in the diagnosis of neuroblastoma in children.Methods:A total of 48 children with neuroblastoma were taken as the neuroblastoma group.Meantime,50 children who were excluded from neuroblastoma after caming to the hospital for abdominal distension,diarrhea,constipation,vomiting and other reasons were selected as the control group.All of them underwent color Doppler ultrasonography.Quantitative real-time PCR(qRT-PCR)was applied to detect the levels of serum MYCN mRNA and Smad7 mRNA.ROC curve was drawn to analyze the diagnostic efficacy of serum MYCN mRNA and Smad7 mRNA for neuroblastoma.Concordance Kappa test was applied to analyze the consistency of each diagnostic method with surgical or puncture pathological results.Results:Serum levels of MYCN mRNA and Smad7 mRNA in neuroblastoma group were obviously higher than those in control group(all P<0.05).The AUC of serum MYCN mRNA and Smad7 mRNA in the diagnosis of neuroblastoma was 0.867(95%CI:0.795 to 0.938)and 0.818(95%CI:0.734 to 0.901),respectively,and the specificity was 88.00%and 84.00%,respectively,both had a sensitivity of 75.00%.There were 8 false positives and 11 false negatives in the ultrasonography results,which were highly consistent with the surgical or puncture pathological results,with a Kappa value of 0.612(P<0.05).Ultrasound combined with serum MYCN mRNA and Smad7 mRNA test results showed 9 false positives and 4 false negatives,which were highly consistent with the results of surgery or biopsy,with a Kappa value of 0.735(P<0.05).The sensitivity of ultrasound combined with serum MYCN mRNA and Smad7 mRNA in the diagnosis of neuroblastoma was obviously higher than that of the three alone(all P<0.05).Conclusion:Ultrasound examination has a high diagnostic value for childhood neuroblastoma,and its diagnostic value can be improved to a certain extent when combined with serum MYCN mRNA and Smad7 mRNA.