DCE-CT检查联合血清学相关标志物水平检测对肾癌患者诊断ROC曲线的影响

Influence of DCE-CT examination combined with serological-related marker level detection on ROC curve in diagnosis of renal cancer patients

目的探讨增强CT(DCE-CT)联合血清学相关标志物水平检测对肾癌患者诊断效能的影响。方法选取108例我院2019年4月~2021年7月就诊的疑似肾癌患者,入院后均行DCE-CT检查及血清相关标志物[基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)、畸胎瘤衍生生长因子-1(Teratoma derived growth factor-1,Cripto-1)、肾损伤分子-1(Kidney injury molecule-1,KIM-1)]检测,以病理检查结果为“金标准”,统计DCE-CT检查诊断结果,并比较肾恶性、良性病灶患者血清相关标志物水平,受试者工作特征曲线(ROC)及ROC下面积(AUC)分析其对肾癌诊断价值,比较DCE-CT单独及联合血清相关标志物检测诊断效能。结果经病理诊断显示,108例疑似肾癌患者恶性病灶75例,良性病灶33例;经DCE-CT诊断显示,恶性病灶63例,与良性病灶患者比较,恶性病灶患者血清MMP-9、Cripto-1、KIM-1水平较高(P<0.05);血清MMP-9、Cripto-1、KIM-1诊断AUC分别为0.827、0.779、0.872;经DCE-CT联合血清MMP-9、Cripto-1、KIM-1检查,对于肾恶性病灶诊断AUC为0.928(95%CI:0.896~0.963),灵敏度为93.33%、准确率91.67%。结论DCE-CT检查联合血清MMP-9、Cripto-1、KIM-1水平检测对于肾癌具有较高诊断价值,临床可通过其进行早期筛查诊断,以提高诊断准确率,改善患者预后。

Objective To investigate the effect of contrast-enhanced computed tomography(DCE-CT)combined with the detection of serological markers on the diagnostic efficacy of renal cancer patients.Methods A total of 108 patients with suspected renal cancer who were treated in our hospital from April 2019 to July 2021 were selected.After admission,DCE-CT examination and serum related markers[Matrix metalloproteinase-9(MMP-9)were performed,teratoma derived growth factor-1(Cripto-1),kidney injury molecule-1(Kidney injury molecule-1,KIM-1)]detection,with pathological examination results as the“gold standard”,the diagnostic results of DCE-CT were analyzed,and the levels of serum-related markers in patients with renal malignant and benign lesions were compared,receiver operating characteristic curve(ROC)and area under ROC(AUC)were analyzed to analyze their diagnostic value for renal cancer,and DCE was compared.The diagnostic efficacy of CT alone and in combination with serum-related markers.Results Pathological diagnosis showed that 108 patients with suspected renal cancer had 75 malignant lesions and 33 benign lesions;DCE-CT diagnosis showed that 63 malignant lesions.Compared with benign lesions,serum MMP-9,Cripto-1.The level of KIM-1 was higher(P<0.05);The AUC of serum MMP-9,Cripto-1 and KIM-1 were 0.827,0.779 and 0.872 respectively;the AUC for the diagnosis of renal malignant lesions was 0.928(95%CI:0.896~0.963),with a sensitivity of 93.33% and an accuracy of 91.67%.Conclusion DCE-CT examination combined with the detection of serum MMP-9,Cripto-1 and KIM-1 levels has high diagnostic value for renal cancer.It can be used for early screening and diagnosis in clinic to improve the diagnostic accuracy and improve the prognosis of patients.