DCE-MRI定量参数联合血清B7-H4水平在卵巢癌诊断及分期中的应用价值

Value of DCE-MRI Quantitative Parameters Combined with Serum B7-H4 Level in the Diagnosis and Staging of Ovarian Cancer

目的:探究动态对比增强磁共振成像(DCE-MRI)定量参数联合血清B7同源体4(B7-H4)水平在卵巢癌诊断及分期中的应用价值。方法:选取2019年4月—2022年4月于南通市第二人民医院诊治的100例卵巢癌患者为研究组;并选取同期在本院进行体检的112例健康女性为对照组。所有研究对象均进行DCE-MRI检查及血清B7-H4水平的测定。比较两组DCE-MRI定量参数[速率常数(K_(ep))、血管外细胞外间隙容积分数(V_(e))、容量转移常数(K^(trans))]和血清B7-H4水平;比较不同分期卵巢癌患者DCE-MRI定量参数和血清B7-H4及其与卵巢癌分期的相关性;采用ROC曲线分析DCE-MRI定量参数联合血清B7-H4水平对卵巢癌的诊断效能及在疾病分期中的应用。结果:研究组K_(ep)、V_(e)、K^(trans)、B7-H4水平明显高于对照组,差异有统计学意义(P<0.05)。ROC曲线结果显示,K_(ep)的曲线下面积(AUC)为0.677(95%CI:0.605,0.749);V_(e)的AUC为0.724(95%CI:0.656,0.793);K^(trans)的AUC为0.667(95%CI:0.594,0.741);B7-H4的AUC为0.702(95%CI:0.632,0.773);联合诊断的AUC为0.863(95%CI:0.815,0.911)。不同分期卵巢癌患者K_(ep)、V_(e)、K^(trans)、B7-H4水平比较,差异有统计学意义(P<0.05)。K_(ep)、V_(e)、K^(trans)、B7-H4水平与卵巢癌分期均呈显著正相关(P<0.05)。结论:DCE-MRI定量参数与血清B7-H4水平能有效诊断卵巢癌,同时判断临床分期,且其联合诊断卵巢癌效能更好。

Objective:To explore the use of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with serum B7 homolog 4(B7-H4)levels in the diagnosis and staging of ovarian cancer.Method:A total of 100 ovarian cancer patients diagnosed and treated in the Second People's Hospital of Nantong from April 2019 to April 2022 were selected as the study group;meanwhile,112 healthy women who underwent physical examination in our hospital during the same period were selected as the control group.All subjects underwent DCE-MRI and serum B7-H4 levels were determined.DCE-MRI quantitative parameters[rate constant(K_(ep)),extracellular space volume fraction(V_(e)),volume transfer constant(K^(trans))]and serum B7-H4 levels were compared between the two groups;the correlation between DCE-MRI quantitative parameters and serum B7-H4 and ovarian cancer stage in patients with different stages were compared;ROC curve was used to analyze the diagnostic efficacy of DCE-MRI quantitative parameters combined trans with serum B7-H4 level in ovarian cancer and its application on disease staging.Result:The levels of K_(ep),V_(e),K and B7-H4 in the study group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).ROC curve results showed that the area under the curve(AUC)of K_(ep) was 0.677(95%CI:0.605,0.749);the AUC of V_(e) was 0.724(95%CI:0.656,trans 0.793);the AUC of K was 0.667(95%CI:0.594,0.741);the AUC of B7-H4 was 0.702(95%CI:0.632,0.773);the AUC of combined diagnosis was 0.863(95%CI:trans 0.815,0.911).There were significant differences in K_(ep),V_(e),K and B7-H4 levels in ovarian cancer patients with different stages(P<0.05).trans K_(ep),V_(e),K and B7-H4 levels were significantly positively correlated with ovarian cancer staging(P<0.05).Conclusion:The quantitative parameters of DCE-MRI combined with serum B7-H4 level can effectively diagnose ovarian cancer while judging clinical stage,and its combination has better efficacy in diagnosing ovarian cancer.