多层螺旋CT联合血清糖类抗原125对腹膜后副神经节瘤的诊断价值

Value of multislice spiral CT combined with serum CA125 in the diagnosis of retroperitoneal paraganglioma

目的探讨多层螺旋CT联合血清糖类抗原125(CA125)对腹膜后副神经节瘤的诊断价值。方法回顾性分析2016年1月至2022年5月海安市人民医院收治的72例腹膜后副神经节瘤患者(研究组)及56例腹膜后副神经鞘瘤患者(对照组)的临床资料。采用酶联免疫吸附试验(ELISA)检测患者血清糖类抗原125(CA125)水平,并行多层螺旋CT检查,比较两组多层螺旋CT影像学表现、CT值及强化率。绘制受试者工作特征(ROC)曲线,分析多层螺旋CT联合血清CA125对腹膜后副神经节瘤的诊断价值。结果研究组血清CA125水平高于对照组[(242.37±28.29)kU/L vs.(205.71±22.18)kU/L,t=7.974,P<0.001]。在多层螺旋CT影像学表现方面,研究组周边囊变/坏死比例高于对照组(20.83%vs.3.57%,P<0.05),两组类圆形或圆形病灶、钙化、囊变/坏死、出血、边界清楚、均匀度为均匀的比例及病灶大小差异无统计学意义(P>0.05)。研究组平均CT值、动脉期CT值、静脉期CT值、动脉期强化率均高于对照组(P<0.05),两组静脉期强化率比较差异无统计学意义(P>0.05)。ROC曲线结果显示,平均CT值、动脉期CT值、静脉期CT值、动脉期强化率及血清CA125水平五者联合诊断腹膜后副神经节瘤的曲线下面积(AUC)值、敏感度、特异度、约登指数等诊断效能均优于各指标单独诊断。结论多层螺旋CT参数联合血清CA125水平对诊断腹膜后副神经节瘤的诊断价值优于单独诊断。

Objective To investigate the diagnostic value of multi-slice spiral CT combined with serum carbohydrate antigen 125(CA125)in retroperitoneal paraganglioma.Methods The clinical data of 72 patients with retroperitoneal paraganglioma(the study group)and 56 patients with retroperitoneal accessory schwannoma(the control group)admitted to the People's Hospital of Hai'an City from January 2016 to May 2022 were retrospectively analyzed.Serum CA125 levels were detected by enzyme-linked immunosorbent assay(ELISA),and the imaging findings,CT values and enhancement rate of the two groups were compared by multi-slice spiral CT.Receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of multislice spiral CT combined with serum CA125 in retroperitoneal paraganglioma.Results The serum CA125 level in the study group was higher than that in the control group[(242.37±28.29)kU/L vs.(205.71±22.18)kU/L,t=7.974,P<0.001].In terms of the imaging findings of multi-slice spiral CT,the proportion of cystic lesion/necrosis location in the study group was higher than that in the control group(20.83%vs.3.57%,P<0.05),but there was no statistically significant difference between the two groups in the proportion of lesions with circular or circular shape,calcification,cystic lesion/necrosis,bleeding,lesion size,clear boundary and uniformity(P>0.05).The average CT value,arterial CT value,venous CT value and arterial enhancement rate of the study group were higher than those of the control group(P<0.05),but there was no statistical significance in the rate of venous enhancement between the two groups(P>0.05).ROC curve results showed that average CT value,arterial CT value,venous CT value,arterial enhancement rate and serum CA125 level in the combined diagnosis of retroperitoneal paraganglioma area under the curve(AUC)value,sensitivity,specificity,Yoden index and other diagnostic efficacy were better than each index alone diagnosis.Conclusions Multi-slice spiral CT parameters(mean CT value,arterial CT value,venous CT value,arterial enhancement rate)combined with serum CA125 level is better than each index alone in the diagnosis of retroperitoneal paraganglioma.