动态增强MRI定量参数联合CA15-3、外周血CTC对乳腺癌的诊断价值和预后预测价值分析

Analysis of the Diagnostic Value and Prognostic Value of Dynamic Contrast Enhanced MRI Quantitative Parameters Combined with CA15-3 and Peripheral Blood CTC in Breast Cancer

目的:探讨动态增强磁共振成像(DCE-MRI)定量参数联合糖类抗原15-3(CA15-3)、外周血循环肿瘤细胞(CTC)诊断乳腺癌和预测其预后的价值。方法:选择2018年1月至2020年1月我院收治的95例乳腺癌患者(恶性组)和101例良性乳腺病变患者(良性组)。所有患者均接受DCE-MRI检查和血清CA15-3、外周血CTC检测,乳腺癌患者术后随访3年,根据生存情况将患者分为死亡组和存活组。受试者工作特征(ROC)曲线分析DCE-MRI参数和CA15-3、CTC联合诊断乳腺癌和预测乳腺癌预后的价值。结果:恶性组速率常数(Kep)、容积转移常数(Ktrans)、血管外细胞外容积分数(Ve)、血清CA15-3、外周血CTC高于良性组(P<0.05)。随访期间2例失访,死亡45例,存活48例,死亡组Kep、Ktrans、Ve、血清CA15-3、外周血CTC高于存活组(P<0.05)。联合Kep、Ktrans、Ve、血清CA15-3、外周血CTC诊断乳腺癌以及预测乳腺癌预后的曲线下面积为0.865、0.908,均高于单独诊断及预测。结论:乳腺癌患者DCE-MRI参数Kep、Ktrans、Ve值以及血清CA15-3、外周血CTC水平均增加,联合DCE-MRI参数和血清CA15-3、外周血CTC可提高对乳腺癌诊断和预后预测效能。

Objective:To investigate the value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)quantitative parameters combined with carbohydrate antigen 15-3(CA15-3)and peripheral blood circulating tumor cells(CTC)in the diagnosis and prognosis of breast cancer.Methods:95 breast cancer patients(malignant group)and 101 benign breast lesions patients(benign group)who were admitted to our hospital from January 2018 to January 2020 were selected.All patients underwent DCE-MRI examination and serum CA15-3 and peripheral blood CTC detection,breast cancer patients were followed up for 3 years,patients were divided into death group and survival group according to the survival situation.The value of DCE-MRI parameters combined with CA15-3 and CTC in the diagnosis and prognosis of breast cancer were analyzed by receiver operating characteristic(ROC)curve.Results:The rate constant(Kep),volume transfer constant(Ktrans),extravascular extracellular volume fraction(Ve),serum CA15-3 and peripheral blood CTC in malignant group were higher than those in benign group(P<0.05).During the follow-up period,2 cases were lost to follow-up,45 cases died and 48 cases survived,Kep,Ktrans,Ve,serum CA15-3 and peripheral blood CTC in death group were higher than those in survival group(P<0.05).The area under the curve of combined Kep,Ktrans,Ve,serum CA15-3 and peripheral blood CTC in the diagnosis of breast cancer and the prediction of breast cancer prognosis was 0.865 and 0.908 respectively,which were higher than those of single diagnosis and prediction.Conclusion:The values of DCE-MRI parameters Kep,Ktrans,Ve,serum CA15-3 and peripheral blood CTC levels are increase in breast cancer patients,the combination of DCE-MRI parameters,serum CA15-3 and peripheral blood CTC can improve the diagnosis and prognosis of breast cancer.