食管癌的CT及MRI影像表现与血清CEA、Cyfra21-1、SCC-Ag、CA19-9、CA72-4表达的相关性及其诊断价值分析

Correlation Between CT and MRI Findings of Esophageal Carcinoma and The Expression of Serum CEA,Cyfra21-1,SCC-Ag,CA19-9,CA72-4 and Its Diagnostic Value

目的探讨食管癌的电子计算机断层扫描仪器(CT)及磁共振成像(MRI)影像表现与血清癌胚抗原(CEA)、细胞角化素蛋白19片段(Cyfra21-1)、鳞状细胞癌相关抗原(SCC-Ag)、糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)表达的相关性及其诊断价值分析。方法将我院2019年4月至2022年4月纳入的64例食管癌患者作为观察组,另外,同期56例在我院进行健康体检者作为对照组。观察食管癌的CT及MRI的影像表现,比较两组的血清CEA、Cyfra21-1、SCC-Ag、CA19-9、CA72-4水平,分析食管癌的CT及MRI影像表现与血清CEA、Cyfra21-1、SCC-Ag、CA19-9、CA72-4表达的关系及相关性,进一步探讨食管癌的CT及MRI影像表现与血清CEA、Cyfra21-1、SCC-Ag、CA19-9、CA72-4单项及联合检测在食管癌中的诊断结果、诊断效能。结果CT检查显示:食管壁结节样病变,向腔内突出,管腔偏心性狭窄,管腔呈点状改变。食管壁环形增厚,管腔向心性狭窄,邻近气管隆突下淋巴结转移。MRI检查显示:管壁明显增厚,管腔狭窄,邻近纵隔淋巴结肿大;病变于T1WI显示为等信号,T2WI显示为较高信号,DWI显示为明显高信号,增强扫描出现明显强化。与对照组比较,观察组的血清CEA、Cyfra21-1、SCC-Ag、CA19-9、CA72-4水平显著增高(P<0.05)。病灶>3cm、肿瘤边缘粗糙、有淋巴结转移的食管癌患者的血清CEA、Cyfra21-1、SCC-Ag、CA19-9、CA72-4水平高于病灶≤3cm、肿瘤边缘光滑、无淋巴结转移的食管癌患者(P<0.05);肿瘤位置在食管中段的食管癌患者的血清CEA、Cyfra21-1、SCC-Ag、CA19-9、CA72-4水平高于肿瘤位置在食管上段、食管下段的食管癌患者(P<0.05)。经Pearson相关分析显示,食管癌肿瘤边缘与血清CA19-9、CA72-4水平呈正相关(P<0.05);食管癌淋巴结转移与血清CEA、CA19-9、CA72-4水平呈正相关(P<0.05);食管癌肿瘤位置与血清CEA、CA72-4水平呈正相关(P<0.05)。经ROC曲线结果表明,食管癌的CT及MRI影像表现与血清CEA、Cyfra21-1、SCC-Ag、CA19-9、CA72-4联合检测诊断食管癌的灵敏度(96.80%)、特异度(94.70%)、准确度(95.80%)高于单项检测(P<0.05)。结论食管癌采用CT及MRI检查可以获取较多的诊断信息,清晰显示病变区域,并且血清CEA、Cyfra21-1、SCCAg、CA19-9、CA72-4水平变化能够用于判断食管癌患者病情的严重程度。另外,食管癌的CT及MRI影像表现与血清CEA、Cyfra21-1、SCC-Ag、CA19-9、CA72-4水平具有相关性,而且用于食管癌患者可以提高早期诊断的检出率,在临床中具有较高的诊断价值。

Objective To investigate the correlation between CT and magnetic resonance imaging(MRI)manifestations of esophageal cancer and the expression of serum carcinoembryonic antigen(CEA),cytokeratin 19 fragment(Cyfra21-1),squamous cell carcinoma associated antigen(SCC-Ag),carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 72-4(CA72-4)and their diagnostic value.Methods 64 patients with esophageal cancer who were included in our hospital from April 2019 to April 2022 were taken as the observation group,and 56 patients who underwent physical examination in our hospital at the same time were taken as the control group.To observe the imaging manifestations of CT and MRI,compare the levels of serum CEA,Cyfra21-1,SCC-Ag,CA19-9,CA72-4 between the two groups,analyze the relationship and correlation between CT and MRI imaging characteristics of esophageal cancer patients and the levels of serum CEA,Cyfra21-1,SCC-Ag,CA19-9,CA72-4,and further explore the diagnostic results and diagnostic efficacy of CT and MRI and serum CEA,Cyfra21-1,SCC-Ag,CA19-9,CA72-4 in esophageal cancer.Results CT examination showed that the nodular lesions of the esophageal wall protruded into the lumen,the lumen was eccentric stenosis,and the lumen was dotted.The esophageal wall is annular thickened,the lumen is centripetal narrow,and lymph nodes adjacent to the tracheal carina metastasize.MRI examination showed that the wall of the tube was obviously thickened,the lumen was narrow,and the adjacent mediastinal lymph nodes were enlarged;The lesions showed equal signal on T1WI,high signal on T2WI,high signal on DWI,and obvious enhancement on enhanced scan.Compared with the control group,the levels of serum CEA,Cyfra21-1,SCC-Ag,CA19-9 and CA72-4 in the observation group were significantly higher(P<0.05).The serum CEA,Cyfra21-1,SCC-Ag,CA19-9,CA72-4 levels in patients with esophageal cancer with lesions>3cm,rough tumor margins,and lymph node metastasis were higher than those in patients with esophageal cancer with lesions≤3 cm,smooth tumor margins,and no lymph node metastasis(P<0.05);The serum CEA,Cyfra21-1,SCC-Ag,CA19-9,CA72-4 levels in patients with esophageal cancer whose tumor location was in the middle of the esophagus were higher than those in patients with esophageal cancer whose tumor location was in the upper and lower segments of the esophagus(P<0.05).Pearson correlation analysis showed that the tumor margin of esophageal cancer was positively correlated with serum CA19-9 and CA72-4 levels(P<0.05);Lymph node metastasis of esophageal cancer was positively correlated with serum CEA,CA19-9,CA72-4 levels(P<0.05);The tumor location of esophageal carcinoma was positively correlated with serum CEA and CA72-4 levels(P<0.05).The results of ROC curve showed that the sensitivity(96.80%),specificity(94.70%)and accuracy(95.80%)of combined detection of CT and MRI with serum CEA,Cyfra21-1,SCC-Ag,CA19-9,CA72-4 in the diagnosis of esophageal cancer were higher than those of single detection(P<0.05).Conclusion CT and MRI can obtain more diagnostic information for esophageal cancer,clearly display the lesion area,and the changes of serum CEA,Cyfra21-1,SCC-Ag,CA19-9,CA72-4 levels can be used to judge the severity of the disease of esophageal cancer patients.In addition,CT and MRI imaging characteristics of esophageal cancer patients are correlated with serum CEA,Cyfra21-1,SCC-Ag,CA19-9,CA72-4 levels.Moreover,it can improve the detection rate of early diagnosis in patients with esophageal cancer,and has high clinical diagnostic value.