乳腺癌MRI-DWI参数与CA125、CA153表达的相关性及其诊断价值研究

Correlation of MRI-DWI Parameters with CA125 and CA153 Expression in Breast Cancer and Their Diagnostic Value

目的研究乳腺癌磁共振-弥散加权成像(MRI-DWI)参数与糖类抗原125(CA125)、糖类抗原153(CA153)表达相关性及诊断价值。方法选取88例疑似乳腺癌患者作为研究对象,所有患者均接受MRI-DWI、动态增强以及血清CA125和CA153检查,以术后病理学检查作为金标准,分析MRI-DWI诊断阳性率以及阳性患者和阴性患者MRI-DWI参数、血清CA125和CA153水平,并分析MRI-DWI参数与CA125、CA153表达的相关性,以及MRI-DWI与血清CA125、CA153对于乳腺癌的诊断价值。结果经过诊断价值ROC曲线图分析发现,当b值为800 s/mm^(2)时DWI对乳腺癌诊断价值最高;与阴性组相比,阳性组病灶早期信号强化、峰值信号强化、CA125和CA153水平显著更高,b值800 s/mm^(2)时ADC值显著降低;Spearman相关分析结果显示,早期强化率、峰值强化率与血清CA125和CA153水平呈正相关,DWI图像b值取值与患者的血清CA125和CA153水平呈负相关(P<0.05);分析发现,当b值为800 s/mm^(2)时DWI对乳腺癌诊断价值最高(AUC=0.823);MRI-DWI诊断乳腺癌灵敏度为81.0%,特异性为55.6%;血清CA125诊断乳腺癌灵敏度为77.7%,特异性为75.9%;血清CA153诊断乳腺癌灵敏度为66.7%,特异性为79.7%;MRI-DWI联合血清CA125、CA153诊断乳腺癌灵敏度为88.9%,特异性为86.1%。因此得出:MRI-DWI联合血清CA125、CA153诊断价值远高于各项单独检测(P<0.05)。结论乳腺癌MRI-DWI参数与血清CA125、CA153表达存在明显的相关性,且三者联合诊断乳腺癌灵敏度和特异性均高于各项单独检测,应用价值较高。

Objective To investigate the correlation of magnetic resonance diffusion imaging-diffusion weighted imaging(MRI-DWI)parameters with carbohydrate antigen 125(CA125)and CA153 expression in breast cancer,and to evaluate their diagnostic value.Methods 88 patients with suspected breast cancer were enrolled.MRI-DWI examination and dynamic contrast scan along with the detection of CA125 and CA153 were performed in all patients.Taking pathological results as the gold standard,the positive diagnostic rate of MRI-DWI was analyzed,and the MRI-DWI parameters,serum levels of CA125 and CA153 were compared between positive and negative patients.The correlation of MRI-DWI parameters with CA125 and CA153 expressions was discussed,thereafter,the value of MRI-DWI,serum CA125 and CA153 in the diagnosis of breast cancer was evaluated.Results Receiver Operating Characteristic(ROC)curve showed that DWI had the highest diagnostic value for breast cancer when the b-value was 800 s/mm^(2).Early enhancement,peak enhancement,serum CA125 and CA153 levels of positive group were significantly higher than those of negative group,and the apparent coefficient diffusion(ADC)values at b values of 800 s/mm^(2)of positive group were obviously lower than those of negative group.The result of spearman showed that early enhancement rate and peak enhancement rate were positively correlated with serum CA125 and CA153 levels,and the ADC values of DWI at b values were negatively correlated with the serum CA125 and CA153 levels in breast cancer patients(P<0.05).Analysis found that DWI had the highest diagnostic value for breast cancer when the b-value was 800 s/mm^(2)(AUC=0.823).In the diagnosis of breast cancer,the sensitivity and specificity were 81.0%and 55.6%under MRI-DWI curve,those were 77.7%and 75.9%under CA125 curve,and were 66.7%and 79.7%under CA153 curve,while the combined detection of MRI-DWI parameters with CA125 and CA153 expression showed sensitivity and specificity of 88.9%and 86.1%,indicating that the diagnostic value of MRI-DWI combined with serum CA125 and CA153 levels was better than the separate examination(P<0.05).Conclusion MRI-DWI parameters are closely related to the serum expression of CA125 and CA153 in breast cancer patients,the sensitivity and specificity of combined tests are better than those of separate test,which is of great diagnostic value.