3.0T HR-MRI联合血清MMP9、AGR2对宫颈癌FIGO分期诊断价值

Diagnostic value of 3.0T high resolution magnetic resonance imaging combined with the levels of serum matrix metalloproteinase 9 and pre gradient protein 2 for the FIGO staging of cervical cancer of patients

目的:探讨3.0T高分辨磁共振成像(HR-MRI)联合血清基质金属蛋白9(MMP9)、前梯度蛋白2(AGR2)诊断宫颈癌FIGO分期价值。方法:选取2016年3月-2022年10月本院诊疗的122例宫颈癌患者临床资料,依据FIGO分期系统分为Ⅰ~Ⅱ期64例、Ⅲ~Ⅳ期58例,均行3.0T HR-MRI检查,并采用酶联免疫吸附法检测血清MMP9、AGR2水平。采用一致性Kappa检验分析HR-MRI单独及联合血清MMP9、AGR2与术后病理结果的一致性,并绘制受试者工作特征(ROC)曲线分析各指标诊断宫颈癌FIGO分期效能;结果:FIGO分期Ⅲ~Ⅳ期宫颈癌患者血清MMP9、AGR2水平高于Ⅰ~Ⅱ期患者(P<0.05)。血清MMP9、AGR2诊断宫颈癌Ⅰ~Ⅱ期与Ⅲ~Ⅳ期的曲线下面积(AUC)分别为0.789(95%CI0.708-0.869)、0.836(95%CI0.765-0.906),特异度分别为76.6%、73.4%,敏感度分别为72.4%、81.3%,截断值分别为178.83ng/ml、13.18ng/ml。HR-MRI检查与术后病理结果一致性较高,Kappa值为0.739,HR-MRI联合血清MMP9、AGR2检查与术后病理结果一致性极高,Kappa值为0.868(均P<0.05)。HR-MRI联合血清MMP9、AGR2诊断宫颈癌患者FIGO分期的特异度(95.3%)、阳性预测值(94.6%)显著高于各单独指标诊断,敏感度(91.4%)、阴性预测值(92.4%)高于血清MMP9,准确度(93.4%)高于血清MMP9、AGR2(P<0.05)。结论:3.0T HR-MRI联合血清MMP9、AGR2对宫颈癌FIGO分期的诊断价值较高。

Objective:To explore the diagnostic value of 3.0T high-resolution magnetic resonance imaging(HR-MRI)combined with the levels of serum matrix metalloproteinase 9(MMP 9)and pre gradient protein 2(AGR2)for the FI-GO staging of cervical cancer of patients.Methods:The clinical data of 122 patients with cervical cancer who were di-agnosed and treated in hospital from March 2016 to October 2022 were selected in this study.According to the FIGO staging system of cervical cancer,64 patients with cervical cancer Ⅰ-Ⅱ stage were in group A and 58 patients with cer-vical cancer Ⅲ-Ⅳ stage were in group B.The patients in the two groups were examined by 3.0T HR-MRI,and the lev-els of serum MMP9 and AGR2 of the patients in the two groups were measured by enzyme linked immunosorbent as-say(ELISA).Based on the postoperative pathological results,the consistency of between 3.0T HR MRI alone and 3.0.T HR MRI combined with the serum MMP9 and AGR2 levels for diagnosing the FIGO staging of cervical cancer of pa-tients was analyzed by consistency Kappa test.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of the serum MMP9 and AGR2 levels and the parameters of 3.0T HR-MRI of the patients with cer-vical cancer for their FIGO stage.Results:The levels of serum MMP9 and AGR2 of the patients in group B were sig-nificantly higher than those of the patients in group A(P<0.05).The area under curve(AUC)of the serum MMP9 level and the AGR2 level of the patients for diagnosing their cervical cancer stageⅠ-Ⅱ or stageⅢ-Ⅳ were 0.789(95%CI 0.708-0.869)and 0.836(95%CI 0.765-0.906),the specificity of which were 76.6%and 73.4%,the sensitivity of which were 72.4%and 81.3%,and the cut-off values of which were 178.83 ng/ml and 13.18 ng/ml.The consistency of 3.0T HR-MRI with the postoperative pathologic results was high,with the Kappa value of 0.739.The consistency between the combined 3.0T HR-MRI and the serum MMP9 and AGR2HR levels and the postoperative pathologic re-sults was the highest,with the Kappa value of 0.868(all P<0.05).The specificity(95.3%)and the positive predictive value(94.6%)of 3.0T HR-MRI combined the serum MMP9 and AGR2 levels for diagnosing the FIGO staging of the cervical cancer of the patients were significantly higher than those of 3.0T HR-MRI,the serum MMP9 level or the AGR2 level alone.The sensitivity(91.4%)and the negative predictive value(92.4%)of 3.0T HR-MRI combined the serum MMP9 and AGR2 levels for diagnosing the FIGO staging of the cervical cancer of the patients were significantly higher than those of the serum MMP9 level.The accuracy(93.4%)of 3.0T HR-MRI combined the serum MMP9 and AGR2 levels for diagnosing the FIGO staging of the cervical cancer of the patients was significantly higher than that of the serum MMP9 level and that of the serum AGR2 level(P<0.05).Conclusion:3.0T HR-MRI combined with THE serum MMP9 and AGR2 levels for the FIGO staging of the cervical cancer of the patients has diagnostic higher value.