多层螺旋CT联合波形蛋白在腹部去分化脂肪肉瘤中的诊断价值

Diagnostic value of multi⁃slice spiral CT combined with vimentin in dedifferentiated liposarcoma

目的 探讨多层螺旋CT联合波形蛋白(vimentin)在腹部去分化脂肪肉瘤(DDL)中的诊断价值。方法 选取联勤保障部队第九○四医院2017年6月至2022年6月收治的88例疑似DDL患者作为研究对象,均接受多层螺旋CT技术检查,并检测vimentin的表达水平,以病理诊断为金标准,比较多层螺旋CT检查结果与病理诊断的一致性,比较DDL患者与非DDL患者vimentin表达情况,分析多层螺旋CT联合vimentin在去分化脂肪肉瘤中的诊断价值。结果 病理诊断结果显示,88例疑似DDL患者中,共有64例确诊为DDL患者,其余24例均为非DDL患者;多层螺旋CT检查诊断出63例DDL患者,其中,59例DDL与病理诊断一致,20例非DDL与病理诊断一致,经Kappa一致性检验,Kappa=0.746,P<0.01,2种诊断方法的一致性一般。病理诊断为DDL的64例患者中,有59例vimentin表达结果为阳性,5例为阴性;非DDL的24例患者中,6例vimentin表达结果为阳性,18例为阴性。经Kappa一致性检验,Kappa=0.681,P<0.01,2种诊断方法的一致性一般;多层螺旋CT联合vimentin表达检测诊断出63例DDL患者,其中61例DDL与病理诊断一致,22例非DDL与病理诊断一致,经Kappa一致性检验,Kappa=0.866,P<0.01,2种诊断方法的一致性较好;多层螺旋CT、vimentin表达检测及联合诊断的敏感度分别为92.18%,92.18%和95.31%,特异度分别为83.34%,75.00%和91.67%,约登指数分别为0.755,0.671和0.870,联合诊断的价值更高。结论 多层螺旋CT联合vimentin表达检测诊断与病理诊断结果比较一致,可在临床上推广使用。

Objective To explore the diagnostic value of multi‐slice spiral CT combined with vimentin in dedifferentiated liposarcoma(DDL).Methods A total of 88 patients with suspected DDL admitted to No.904 Hospital of Joint Logistics Support Force of PLA from June 2017 to June 2022 were enrolled.Multi‐slice spiral CT examination and vimentin detection were performed in all the patients.Pathological results were taken as the golden standard of diagnosis.The consistency of multi‐slice spiral CT examination and pathological results was investigated.The expression of vimentin was compared between DDL patients and non‐DDL patients.The diagnostic value of multi‐slice spiral CT combined with vimentin in dedifferentiated liposarcoma was analyzed.Results Pathological diagnosis showed that 64 patients were diagnosed as DDL and 24 patients were not DDL.The results of multi‐slice spiral CT showed that 63 patients were diagnosed as DDL.CT results of 59 patients with DDL and 20 patients with non‐DDL were consistent with pathological diagnosis.The multi‐slice spiral CT examination and pathological results were generally consistent(Kappa=0.746,P<0.01).The expression of vimentin was positive in 59 DDL patients and negative in 5 DDL patients.The expression of vimentin was positive in 6 non‐DDL patients and negative in 18 non‐DDL patients.Kappa consistency test showed that and the 2 diagnostic methods were generally consistent(Kappa=0.681,P<0.01).Sixty‐three patients were diagnosed as DDL by multi‐slice spiral CT combined with vimentin detection.The combined detection of 61 patients with DDL and 22 patients with non‐DDL were consistent with pathological diagnosis.Kappa consistency test showed that,the 2 diagnostic methods were well consistent(Kappa=0.866,P<0.01).The sensitivities of multi‐slice spiral CT,vimentin detection and their combination were 92.18%,92.18%and 95.31%,respectively;the specificities were 83.34%,75.00%and 91.67%,respectively;the Youden indexes were 0.755,0.671 and 0.870,respectively.The combined use of multi‐slice spiral CT and vimentin detection had higher diagnostic value for DDL.Conclusion The result of multi‐slice spiral CT combined with vimentin detection is consistent with pathological diagnosis and this method can be widely used in clinic.