MRI联合血清CA199、CEA、VEGF-C水平在胆囊癌诊断中的应用

Application of MRI combined with serum CA199, CEA and VEGF-C levels in the diagnosis of gallbladder carcinoma

目的 探讨磁共振成像(MRI)联合血清糖类抗原199(CA199)、癌胚抗原(CEA)、血管内皮生长因子-C(VEGF-C)水平在胆囊癌中的诊断价值。方法 选取2020年5月至2021年10月内蒙古自治区人民医院影像医学科收治的胆囊癌疑似患者80例开展回顾性研究,所有患者均进行MRI检查、肿瘤标志物检测(CA199、CEA、VEGF-C)、病理组织学检查,对比分析单独检测与联合检测的诊断效能,对比阳性患者与阴性患者的MRI影像学特征、肿瘤标志物水平。结果 经病理组织学检查确诊为胆囊癌者20例,胆囊炎60例;MRI单独诊断阳性29例,阴性51例;肿瘤标志物单独诊断阳性30例,阴性50例;MRI联合肿瘤标志物诊断阳性25例,阴性55例。MRI联合肿瘤标志物诊断的特异度、敏感度、准确度均高于MRI、肿瘤标志物检测单独诊断,差异均有统计学意义(P<0.05)。病理组织学诊断为阳性的患者MRI检查影像学分型有厚壁型(55.00%)、结节型(30.00%)、肿块型(15.00%);病理阳性患者CA199、CEA、VEGF-C平均值均高于阴性患者,差异均有统计学意义(P<0.05),病理阳性患者3项指标平均值均在参考范围之外,阴性患者3项指标平均值水平均在参考范围之内。结论 在临床对胆囊癌的诊断中应用MRI检查能够提示胆囊类型,且阴性、阳性患者CA199、CEA、VEGF-C平均值存在差异;采用MRI联合血清CA199、CEA、VEGF-C能够显著提高诊断效能,有助于临床对胆囊癌的早期确诊。

Objective To explore the diagnostic value of magnetic resonance imaging(MRI)combined with serum carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA),and vascular endothelial growth factor C(VEGF-C)levels in gallbladder carcinoma.Methods A retrospective study was conducted on 80 suspected patients with gallbladder carcinoma admitted to the Department of Imaging Medicine,The People's Hospital of the Inner Mongolia Autonomous Region from May 2020 to October 2021.MRI examination,tumor marker detection(CA199,CEA,VEGF-C)and histopathological examination were performed for all patients,and the diagnostic efficacy of single detection and combined detection were compared and analyzed.The MRI imaging features and tumor markers of positive and negative patients were compared.Results Twenty patients were diagnosed with cholecystitis and sixty with cholecystitis by the histopathological examination.MRI diagnosis was positive in 29 cases and negative in 51 cases.Tumor markers were detected positive in 30 cases and negative in 50 cases.The combined diagnosis of MRI and tumor markers was positive in 25 cases and negative in 55 cases.The specificity,sensitivity and accuracy of combined diagnosis were higher than those of MRI and tumor marker detection alone,the differences were statistically significant(P<0.05).The MRI image types of patients diagnosed with positive histopathology were thick-wall type(55.00%),nodule type(30.00%)and mass type(15.00%).The average values of CA199,CEA,and VEGF-C in pathological positive patients were higher than those in negative patients,the differences were statistically significant(P<0.05).The average values of the three indicators in pathological positive patients were all outside the reference range,while the average levels of the three indicators in negative patients were all within the reference range.Conclusion In clinical diagnosis of gallbladder carcinoma,MRI examination can indicate the type of gallbladder,and the average values of CA199,CEA and VEGF-C are different between negative and positive patients.MRI combined with serum CA199,CEA and VEGF-C can significantly improve the diagnostic efficiency and contribute to the early diagnosis of the disease.