MRI多序列成像联合血清肿瘤标志物在宫颈癌诊断及分期评估中的应用观察

Application of MRI Multi-sequence Imaging Combined with Serum Tumor Markers in the Diagnosis and Staging Evaluation of Cervical Cancer

目的探讨磁共振成像(MRI)多序列成像联合血清肿瘤标志物在宫颈癌(CC)诊断及分期评估中的应用价值。方法选取2021年1月至2023年12月在马鞍山市妇幼保健院和马鞍山市人民医院就诊的70例CC患者为CC组,另取同期134例宫颈良性病变患者为良性组。所有患者均进行MRI检查,并测量血清中癌胚抗原(CEA)、甲胎蛋白(AFP)和人附睾蛋白4(HE4)水平。比较两组患者的MRI定量参数、CEA、AFP及HE4水平;分析MRI定量参数联合血清肿瘤标志物诊断CC的价值;比较不同分期CC患者MRI定量参数、CEA、AFP及HE4水平。结果CC组Ktrans、Ve、Kep水平高于良性组(P<0.05);CC组CEA、AFP及HE4水平高于良性组(P<0.05);ROC曲线结果显示,Ktrans诊断CC的曲线下面积(AUC)和截点值分别为0.814、0.25 min,Ve诊断CC的AUC和截点值分别为0.647、0.59%,Kep诊断CC的AUC和截点值分别为0.567、0.037 min,CEA诊断CC的AUC和截点值分别为0.808、0.028μg/L,AFP诊断CC的AUC和截点值分别为0.740、0.031μg/L,HE4诊断CC的AUC和截点值分别为0.774、0.029 U/mL,联合诊断CC的AUC为0.957,高于单项诊断(P<0.05);随着分期升高,Ktrans、Ve、Kep、CEA、AFP及HE4水平依次升高(P<0.05)。结论MRI多序列成像联合血清肿瘤标志物诊断CC具有较高的诊断价值,且可以用于ⅠB~ⅡB期CC患者术前分期评估。

Objective To explore the application value of magnetic resonance imaging(MRI)multi-sequence imaging combined with serum tumor markers in the diagnosis and staging evaluation of cervical cancer(CC).Methods A total of 70 patients with CC treated in Maanshan Maternal and Child Health Care Hospital and Maanshan People's Hospital from January 2021 to December 2023 were enrolled as the CC group,while 134 patients with benign cervical lesions during the same period were enrolled as the benign group.All the patients underwent MRI and their serum levels of carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP)and human epididymal protein 4(HE4)were detected.The quantitative MRI parameters,and serum CEA,AFP and HE4 levels were compared between the two groups.The diagnostic value of quantitative MRI parameters combined with serum tumor markers for CC was analyzed.The quantitative MRI parameters,CEA,AFP and HE4 in patients with different stages of CC were compared.Results The levels of K trans,V e and K ep in the CC group were higher than those in the benign group(P<0.05).The levels of CEA,AFP and HE4 in the CC group were higher than those in the benign group(P<0.05).The results of receiver operator characteristic(ROC)curve analysis showed that the AUC and cut-off values of K trans,V e,K ep,CEA,AFP and HE4 in the diagnosis of CC were(0.814,0.25 min),(0.647,0.59%),(0.567,0.037 min),(0.808,0.028μg/L),(0.740,0.031μg/L)and(0.774,0.029 U/mL),respectively.The AUC of the combined detection was 0.957,which was greater than that of single index(P<0.05).With the increase of staging,the levels of K trans,V e,K ep,CEA,AFP and HE4 were increased(P<0.05).Conclusion MRI multi-sequence imaging combined with serum tumor markers has high value in the diagnosis of CC,which can also be applied in the preoperative staging evaluation in patients with CC at stages IB-IIB.