术前MRI放射组学特征联合血清CA125、CA153、CEA对非雌激素依赖型子宫内膜癌的预测价值

Prognostic value of preoperative MRI radiomic features combined with serum CA125,CA153 and CEA in non-estrogen-dependent endometrial carcinoma

目的分析基于术前磁共振成像(magnetic resonance imaging,MRI)放射组学特征预测非雌激素依赖型子宫内膜癌的价值。方法选取2018年1月至2023年5月于蚌埠医学院第一附属医院收治的子宫内膜癌患者160例为研究对象,确诊为非雌激素依赖型子宫内膜癌的80例患者为研究组,其余雌激素依赖型子宫内膜癌患者80例为对照组。所有受试者均在术前行MRI检查及血清糖类抗原125(CA125)、糖类抗原153(CA153)、癌胚抗原(CEA)水平检测。结果与对照组相比,研究组肿瘤最大径水平较高,表观扩散系数(apparent diffusion coefficients,ADC)mean水平较低,弥漫型占比较高,研究组边界模糊、T1WI信号等或稍低信号、T2WI信号混杂高信号、DWI信号高信号略高(P>0.05)。与Ⅰ~Ⅱ期非雌激素依赖型子宫内膜癌患者相比,Ⅲ~Ⅳ期非雌激素依赖型子宫内膜癌患者肿瘤最大径、血清CA125、CA153、CEA水平较高,ADCmean水平较低(P<0.05)。与MRI参数肿瘤最大径、ADCmean、CA125、CA153、CEA单项诊断相比,联合诊断对非雌激素依赖型子宫内膜癌预测的敏感度、特异度、准确性均较高(P<0.05)。结论MRI放射组学特征联合血清CA125、CA153、CEA预测非雌激素依赖型子宫内膜癌的价值较高。

Objective The analysis showed the value of predicting non-estrogen-dependent endometrial cancer based on preoperative MRI radiomic characteristics.Methods A total of 160 patients with endometrial cancer admitted to The First Affiliated Hospital of Bengbu Medical College from January 2018 to May 2023 were selected as the study objects,80 patients diagnosed with non-estrogen-dependent endometrial cancer were selected as the study group,and the remaining 80 patients with estrogen-dependent endometrial cancer were selected as the control group.All subjects underwent MRI examination and serum carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153)and carcinoembryonic antigen(CEA)levels were detected before surgery.Results Compared with the control group,the maximum diameter of tumor in the study group was higher,the Apparent diffusion coefficients(ADC)mean level was lower,and the proportion of diffuse type was higher.In the study group,the boundary was blurred,the T1WI signal was equal or slightly lower,the T2WI signal was mixed with high signal,and the DWI signal was slightly higher(P>0.05).Compared with patients with stageⅠtoⅡnon-estrogen-dependent endometrial carcinoma,patients with stageⅢtoⅣnonestrogen-dependent endometrial carcinoma had higher tumor maximum diameter,higher serum CA125,CA153 and CEA levels,and lower ADCmean levels(P<0.05).Compared with MRI parameters of maximum tumor diameter,ADCmean,CA125,CA153 and CEA,combined diagnosis had higher sensitivity,specificity and accuracy in predicting non-estrogen dependent endometrial carcinoma(P<0.05).Conclusion MRI radiomic features combined with serum CA125,CA153 and CEA have high value in predicting non-estrogen-dependent endometrial carcinoma.