摘要
目的:探讨动态增强磁共振(dynamic contrast enhanced MRI,DCE-MRI)扫描联合血清上皮钙黏蛋白(soluble E-cadherin,sE-cadherin)、前梯度蛋白2(anterior gradient-2,AGR2)对前列腺癌(prostatic cancer,PCa)的诊断价值。方法:选择2015年02月至2018年02月我院收治的行前列腺穿刺活检经病理确认诊断为前列腺癌(PCa)患者98例记为PCa组,104例前列腺增生(BPH)患者记为BPH组,同时以同期的92例在我院体检的健康男性为对照组。比较PCa组和BPH组的DCE-MRI容量转移常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积比(Ve)、血浆内对比剂容积分数(Vp)以及三组的血清sE-cadherin、AGR2情况。以Logistics回归模型拟合联合诊断,并通过受试者工作特征(receiver operating characteristic,ROC)曲线分析各指标诊断价值。结果:PCa组的血清sE-cadherin、AGR2水平均高于BPH组和对照组(P<0.05),且BPH组高于对照组(P<0.05)。PCa组的Ktrans、Kep、Ve均高于BPH组(P<0.05);两组的Vp比较无统计学差异(P>0.05)。联合诊断的灵敏度82.65%也显著高于Ktrans(60.20%)、Kep(66.33%)、Ve(65.31%)、sE-cadherin(63.27%)、AGR2(58.16%)单独检测,差异均具有统计学意义(P<0.05)。联合检测ROC曲线下面积0.867(95%CI:0.826~0.908),高于Ktrans 0.650(95%CI:0.577~0.722)、Kep 0.693(95%CI:0.621~0.764)、Ve 0.826(95%CI:0.776~0.876)、sE-cadherin 0.807(95%CI:0.753~0.861)、AGR20.759(95%CI:0.701~0.817)分别单独检测。结论:采用DCE-MRI检查血管渗透性参数和血清sE-cadherin及AGR2水平对于前列腺癌诊断具有重要意义,且三者联合检测能够提高诊断的灵敏度和准确度,为前列腺癌的临床诊断提供新的检测依据。
Objective:To study the linical value of DCE-MRI combined with serum sE-cadherin and AGR2 in diagnosis of prostate cancer.Methods:We selected 98 patients with prostate cancer as subjects of PCa group,and 104 patients with benign prostatic hyperplasias subjects of BPH group from February 2015 to February 2018.And 92 healthy men who were healthy in our hospital during the same period were selected as the control group.The Ktrans,Kep,Ve,Vp were compared between PCa group and BPH group.The serum sE-cadherin and AGR2 were compared among the three groups.Logistic regression model was used to fit the joint diagnosis,and the diagnostic value of each index was analyzed by the working characteristic curve of the subjects.Results:Serum sE-cadherin and AGR2 levels in PCa group were higher than those in BPH group and control group(P<0.05),and BPH group was higher than that in control group(P<0.05).The levels of Ktrans,Kep and Ve in PCa group were higher than those in BPH group(P<0.05).There was no significant difference in Vp between the two groups(P>0.05).The sensitivity of combined diagnosis was 82.65%,higher than that of Ktrans(60.20%),Kep(66.33%),Ve(65.31%),sE-cadherin(63.27%),AGR2(58.16%),and the differences were statistically significant.The area under ROC curve was 0.867(95%CI:0.826~0.908),which was higher than Ktrans(0.650,95%CI:0.577~0.722),Kep(0.693,95%CI:0.621~0.764),Ve(0.826,95%CI:0.776~0.876),sE-cadherin(0.807,95%CI:0.753~0.861)and AGR2(0.759,95%CI:0.701~0.817)respectively.Conclusion:Combined detection of vascular permeability parameters Ktrans,Kep,Ve by DCE-MRI,sE-cadherin and AGR2 can improve the sensitivity and accuracy of diagnosis,and provide a new basis for clinical diagnosis of prostate cancer.
作者
崔胜宏
马秀梅
闫红梅
李和英
CUI Shenghong;MA Xiumei;YAN Hongmei;LI Heying(Imaging Department,Northern Hospital of Xi'an,Shaanxi Xi'an 710043,China;Imaging Department,the First Hospital of Yulin,Shaanxi Yulin 719000,China.)
出处
《现代肿瘤医学》
CAS
北大核心
2021年第14期2490-2496,共7页
Journal of Modern Oncology
关键词
动态增强磁共振
上皮钙黏蛋白
前梯度蛋白
前列腺癌
诊断
ROC曲线
dynamic contrast enhanced MRI
soluble E-cadherin
anterior gradient-2
prostatic cancer
diagnosis
receiver operating characteristic
