磁共振联合血清KMT2D检测在膀胱癌诊断中的临床意义

Clinical Significance of Magnetic Resonance Combined with Serum KMT2D Detection in the Diagnosis of Bladder Cancer

目的分析磁共振联合血清组蛋白赖氨酸甲基转移酶2D(KMT2D)检测对膀胱癌的诊断价值。方法以本院154例膀胱癌患者作为膀胱癌组(BC组),根据临床金标准分为肌层浸润性膀胱癌94例(MIBC组)和非肌层浸润性膀胱癌60例(NMIBC组)。对照组为同期100例健康体检者。比较各组血清KMT2D表达水平差异,受试者工作特征(ROC)曲线分析血清KMT2D对MIBC膀胱癌诊断价值。磁共振、血清KMT2D及二者联合诊断与临床“金标准”的一致性采用Kappa检验。结果BC组血清KMT2D表达水平低于对照组,MIBC组KMT2D表达水平低于NMIBC组,差异有统计学意义(P<0.05)。血清KMT2D诊断MIBC膀胱癌的截断值为0.68,曲线下面积为0.855。磁共振检查诊断MIBC膀胱癌与临床“金标准”检查一致性较好(Kappa=0.744,P<0.05)。磁共振检查联合血清KMT2D诊断MIBC膀胱癌与临床“金标准”结果相比的Kappa值为0.932(P<0.05)。磁共振检查联合血清KMT2D诊断MIBC膀胱癌的灵敏度、准确率及特异度优于单独诊断。结论磁共振联合血清KMT2D检测对MIBC膀胱癌诊断价值较高,有助于术前明确膀胱癌浸润程度。

Objective To analyze the diagnostic value of magnetic resonance combined with serum histone lysine methyltransferase 2D(KMT2D)detection in bladder cancer.Methods A total of 154 bladder cancer patients in our hospital were regarded as the bladder cancer group(BC group).According to the clinical gold standard,they were grouped into 94 cases of muscle-invasive bladder cancer(MIBC group)and 60 cases of non-muscle-invasive bladder cancer(NMIBC group).The control group consisted of 100 healthy subjects during the same period.The difference in serum KMT2D expression level in each group was compared,receiver operating characteristic(ROC)curve was used to analyze the serum KMT2D in the diagnosis of MIBC bladder cancer.The consistency of MRI,serum KMT2D and their combined diagnosis with the clinical gold standard was determined by Kappa test.Results The expression level of serum KMT2D in the BC group was lower than that in the control group,and the expression level of KMT2D in the MIBC group was lower than that in the NMIBC group(P<0.05).The cut-off value of serum KMT2D for the diagnosis of MIBC bladder cancer was 0.68,and the area under the curve was 0.855.The MRI diagnosis of MIBC bladder cancer was in good agreement with the clinical gold standard examination(Kappa=0.730,P<0.05).The Kappa value of MRI combined with serum KMT2D in the diagnosis of MIBC bladder cancer was 0.932 compared with the clinical gold standard results(P<0.05).The sensitivity,accuracy and specificity of MRI combined with serum KMT2D in the diagnosis of MIBC bladder cancer were better than those of single diagnosis.Conclusion Magnetic resonance imaging combined with serum KMT2D detection has high diagnostic value for MIBC bladder cancer,which is helpful to determine the degree of bladder cancer invasion before surgery.