多排螺旋CT检测联合血清GLP-1、PINP对乳腺癌术后骨质疏松症的诊断价值

The Value of Multidetector Spiral CT Combined with Serum GLP-1 and PIMP in the Diagnosis of Osteoporosis after Breast Cancer Surgery

目的 探究多排螺旋CT检测联合血清胰高血糖素样肽1(GLP-1)、Ⅰ型前胶原氨基端前肽(PINP)对乳腺癌术后骨质疏松症的诊断价值。方法选取2021年1月至2023年1月本院就诊的152例乳腺癌手术史的患者,根据术后双能X线检测是否出现骨质疏松分为骨质疏松组(62例)和非骨质疏松组(90例);患者均进行多螺旋CT以及双能X线检测;酶联免疫吸附法检测血清GLP-1、PINP水平;受试者工作特征(ROC)曲线分析血清GLP-1、PINP对乳腺癌术后骨质疏松症的临界诊断点;采用四格表分析多排螺旋CT联合血清GLP-1、PINP对乳腺癌术后骨质疏松症的诊断价值。结果骨质疏松组CT值显著低于非骨质疏松组(P<0.05)。骨质疏松组血清GLP-1水平显著低于非骨质疏松组(P<0.05),PINP水平显著高于非骨质疏松组(P<0.05)。血清GLP-1诊断乳腺癌术后骨质疏松症的曲线下面积(AUC)为0.842,血清PINP诊断乳腺癌术后骨质疏松症的AUC为0.881,CT值诊断乳腺癌术后骨质疏松症的AUC为0.889,三者联合诊断乳腺癌术后骨质疏松症的AUC为0.971。多排螺旋CT在乳腺癌术后骨质疏松症诊断中准确度为89.47%,灵敏度为91.11%,特异度为87.10%;GLP-1在乳腺癌术后骨质疏松症诊断中准确度为84.87%,灵敏度为87.78%,特异度为80.65%;PINP在乳腺癌术后骨质疏松症诊断中准确度为82.89%,灵敏度为85.56%,特异度为79.03%;三者联合检测在乳腺癌术后骨质疏松症诊断中准确度为93.42%,灵敏度为94.44%,特异度为91.94%。结论血清GLP-1水平降低,PINP水平升高与乳腺癌术后骨质疏松症发生有关,多排螺旋CT联合血清GLP-1、PINP可提高乳腺癌术后骨质疏松症的诊断价值。

Objective To explore the diagnostic value of multidetector spiral CT combined with serum glucagonlike peptide 1(GLP-1) and type Ⅰ procollagen amino-terminal propeptide(PINP) in the diagnosis of osteoporosis after breast cancer surgery.Methods A total of 152 patients with a history of breast cancer surgery who were admitted to our hospital from January 2021 to January 2023 were divided into osteoporosis group(62 cases) and non-osteoporosis group(90 cases) according to whether osteoporosis occurred after postoperative dual-energy X-ray detection.The patients underwent multispiral CT and dual-energy X-ray detection.Enzyme-linked immunosorbent assay was used to detect serum G LP-1 and PIPP levels.The receiver operating cha racteristic(ROC) cu rve was used to analyze the critical diagnostic point of serum GLP-1 and PIPP for osteoporosis after breast ca ncer surgery.A fou rgrid table was used to analyze the diagnostic value of multidetector spiral CT combined with serum GLP-1 and PIMP in osteoporosis after breast cancer surgery.Results The CT value in the osteoporosis group was significantly lower than that in the non osteoporosis group(P<0.05).The serum GLP-1 level in the osteoporosis group was obviously lower than that in the non osteoporosis group(P<0.05),and the PINP level was obviously higher than that in the non osteoporosis group(P<0.05).The AUC of serum GLP-1 for diagnosis of osteoporosis after breast cancer surgery was 0.842,the AUC of serum PINP for diagnosis of osteoporosis after breast cancer surgery was 0.881,and the AUC of CT value for diagnosis of osteoporosis after breast cancer surgery was 0.889,the AUC of the three combined diagnosis of osteopo rosis after breast ca ncer surgery was 0.971.The accuracy,sensitivity and specificity of multidetector spiral CT in the diagnosis of osteoporosis after breast cancer surgery were 89.47%,91.11% and 87.10%;the accu racy of GLP-1 in the diagnosis of osteoporosis after breast cancer surgery was 84.87%,the sensitivity was 87.78%,and the specificity was 80.65%;the accuracy of PINP in the diagnosis of osteoporosis after breast cancer surgery was 82.89%,the sensitivity was 85.56%,and the specificity was 79.03%;the accuracy,sensitivity and specificity of the combined detection of the three in the diagnosis of osteoporosis after breast cancer surgery were 93.42%,94.44% and 91.94%respectively.Conclusion The decrease of serum G LP-1 level and the increase of PIMP level a re related to the occurrence of osteoporosis after breast cancer surgery,and multidetector CT combined with serum G LP-1 and PIMP can improve the diagnostic value of osteopo rosis after breast ca ncer surgery.