摘要
目的 探讨多层螺旋CT(MSCT)联合血清可溶性B7-H4(B7-H4)、甲壳质酶蛋白 40(YKL-40)对胃癌淋巴结转移的诊断价值.方法 选取 2021 年 1 月至 2023 年 1 月确诊的胃癌患者 114 例,根据患者是否发生淋巴结转移分为转移组 54 例和未转移组 60 例,对患者进行MSCT检查,酶联免疫吸附法(ELISA)检测血清sB7-H4、YKL-40 水平;受试者工作特征(ROC)曲线分析血清sB7-H4、YKL-40 水平对胃癌淋巴结转移的诊断价值;采用Kappa一致性检验分析各方法与病理结果一致性.结果 转移组血清 sB7-H4、YKL-40 水平及强化程度显著高于未转移组(P<0.05).血清sB7-H4、YKL-40 水平诊断胃癌淋巴结转移的曲线下面积(AUC)分别为 0.794、0.811.MSCT、血清sB7-H4、YKL-40 单独及联合检查与病理结果一致性分别为较高、中度、中度、极高,Kappa值分别为 0.721、0.473、0.408、0.859(P<0.05).MSCT联合血清sB7-H4、YKL-40 诊断胃癌淋巴结转移的特异度、阳性预测值显著高于三者单独诊断,准确度、阴性预测值显著高于血清sB7-H4、YKL-40 单独诊断,敏感度高于血清sB7-H4 单独诊断(P<0.05).结论 MSCT联合血清sB7-H4、YKL-40 对于诊断胃癌淋巴结转移有较高的应用价值.
Abstract
Objective To explore the diagnostic value of multi-slice spiral CT(MSCT)combined with serum soluble B7-H4(sB7-H4)and chitinase-3-like protein 1(YKL-40)for lymph node metastasis of gastric cancer.Methods A total of 114 gastric cancer patients diagnosed in our hospital from January 2021 to January 2023 were enrolled.They were grouped into a metastatic group(n=54)and a non metastatic group(n=60)based on whether the presence or absence of lymph node metastasis.All patients were managed by multi-slice spiral computed tomography(MSCT)examinations,the serum levels of sB7-H4 and YKL-40 were detected by enzyme linked immunosorbent assay(ELISA),the receiver operating characteristic(ROC)curve was performed to analyze the diagnostic value of serum sB7-H4 and YKL-40 levels in lymph node metastasis of gastric cancer,the consistency between test methods with pathological results was evaluated by Kappa consistency test.Results The levels of serum sB7-H4 and YKL-40 in metastatic group were obviously higher than those in non metastatic group(P<0.05).The area under the curve(AUC)for diagnosing lymph node metastasis in gastric cancer by serum sB7-H4 and YKL-40 levels was 0.794 and 0.811,respectively.The consistency between MSCT,sB7-H4,and YKL-40 alone,and their combined examination with pathological results was high,moderate,moderate,and extremely high,respectively,with Kappa value of 0.721,0.473,0.408,and 0.859,respectively(P<0.05).The specificity and positive predictive value of MSCT combined with serum sB7-H4 and YKL-40 in diagnosing lymph node metastasis of gastric cancer were obviously higher than those of the three diagnostic methods alone,the accuracy and negative predictive value were obviously higher than those of serum sB7-H4 and YKL-40 for individual diagnosis,while the sensitivity was obviously higher than that of serum sB7-H4 for individual diagnosis(P<0.05).Conclusion The combination of MSCT with serum sB7-H4 and YKL-40 has high practical value in the diagnosis of lymph node metastasis in gastric cancer.
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