MRI增强扫描联合血清CRNDE、NRSN2在鼻咽癌分期诊断及疗效评估中的应用

Application of MRI enhanced scanning combined with serum CRNDE and NRSN2 in the staging diagnosis and efficacy evaluation of nasopharyngeal carcinom

目的 分析MRI增强扫描联合血清结直肠肿瘤差异表达基因(CRNDE)、神经膜蛋白2(NRSN2)在对鼻咽癌分期诊断及疗效评估中的应用。方法 选取收治并经病理检测证实为鼻咽癌的患者110例作为研究对象,根据鼻咽癌分期分为Ⅱ期为早期组46例,Ⅲ期和Ⅳ期为中晚期组64例;所有患者进行MRI增强扫描和放化疗治疗,根据放化疗效果分为疗效良好组和疗效不佳组;采用Pearson法分析血清CRNDE、NRSN2及二者与MRI增强扫描参数的相关性;受试者工作特征(ROC)曲线分析MRI增强扫描参数联合血清CRNDE、NRSN2水平对鼻咽癌分期的诊断价值。结果 中晚期组最大上升斜率、达峰时间、CRNDE以及NRSN2水平均显著高于早期组(P<0.05)。根据Pearson相关性分析得知,血清CRNDE、NRSN2水平呈正相关(P<0.05),二者与最大上升斜率、达峰时间均呈正相关(P<0.05)。根据ROC曲线得知,最大上升斜率诊断鼻咽癌分期的AUC为0.798,达峰时间诊断鼻咽癌分期的AUC为0.854,二者联合诊断鼻咽癌分期的AUC为0.918,二者联合的AUC优于各自单独诊断(Z_(联合vs.最大上升斜率)=2.628、Z_(联合vs.达峰时间)=2.731,P<0.05);CRNDE诊断鼻咽癌分期的AUC为0.841,NRSN2诊断鼻咽癌分期的AUC为0.864,MRI增强扫描诊断鼻咽癌分期的AUC为0.918,三者联合诊断鼻咽癌分期的AUC为0.984,三者联合的AUC优于各自单独诊断(Z_(联合vs.CRNDE)=2.510、Z_(联合vs. NRSN2)=2.685,Z_(联合vs. MRI增强扫描)=2.821,P<0.05)。疗效不佳组最大上升斜率、达峰时间、CRNDE以及NRSN2水平均显著高于疗效良好组(P<0.05)。结论 MRI增强扫描联合血清CRNDE、NRSN2在鼻咽癌分期诊断中具有较高的临床价值,还与患者放化疗疗效密切相关。

Objective To analyze the application of MRI enhanced scanning combined with serum differential expression genes(CRNDE)and neurensin-2(NRSN2)in staging diagnosis and efficacy evaluation of nasopharyngeal carcinoma.Methods A total of 110 patients diagnosed with nasopharyngeal carcinoma were selected as the study subjects.According to the staging,they were divided into the early-stage group(46 cases,StageⅡ)and the middle-to-late-stage group(64 cases,StageⅢandⅣ).All patients underwent MRI enhanced scanning and radiochemotherapy.Based on the efficacy of radiochemotherapy,patients were categorized into the good efficacy group and poor efficacy group.Pearson′s method was used to analyze the correlation between serum CRNDE,NRSN2,and their correlation with MRI enhanced scanning parameters.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the diagnostic value of combined MRI enhanced scanning parameters with serum CRNDE and NRSN2 levels in staging nasopharyngeal carcinoma.Results The maximum upslope,time to peak,CRNDE,and NRSN2 levels in the middle-to-late-stage group were significantly higher than those in the early-stage group(P<0.05).Pearson correlation analysis revealed a positive correlation between serum CRNDE and NRSN2 levels(P<0.05),and both were positively correlated with the maximum upslope and time to peak(P<0.05).According to the ROC curve,the area under the curve(AUC)for diagnosing nasopharyngeal carcinoma staging was 0.798 for the maximum upslope,0.854 for time to peak,and 0.918 for the combination of both,which was superior to individual diagnosis(Z_(combined vs.maximum upslope)=2.628,Z_(combined vs.time to peak)=2.731,P<0.05).The AUC for CRNDE,NRSN2,and MRI enhanced scanning alone in diagnosing nasopharyngeal carcinoma staging was 0.841,0.864,and 0.918,respectively.The AUC for the combination of all three was 0.984,which was superior to individual diagnosis(Z_(combined vs.CRNDE)=2.510,Z_(combined vs.NRSN2)=2.685,Z_(combined vs.MRI enhanced scanning)=2.821,P<0.05).The levels of maximum upslope,time to peak,CRNDE,and NRSN2 in the poor efficacy group were significantly higher than those in the good efficacy group(P<0.05).Conclusion MRI enhanced scanning combined with serum CRNDE and NRSN2 has high clinical value in the staging diagnosis of nasopharyngeal carcinoma,and it is closely related to the efficacy of radiochemotherapy in patients.