摘要
目的 探讨多层螺旋CT联合波形蛋白(vimentin)在腹部去分化脂肪肉瘤(DDL)中的诊断价值.方法 选取联勤保障部队第九○四医院 2017 年 6 月至 2022 年 6 月收治的 88 例疑似DDL患者作为研究对象,均接受多层螺旋CT技术检查,并检测vimentin的表达水平,以病理诊断为金标准,比较多层螺旋CT检查结果与病理诊断的一致性,比较DDL患者与非DDL患者vimentin表达情况,分析多层螺旋CT联合vimentin在去分化脂肪肉瘤中的诊断价值.结果 病理诊断结果显示,88 例疑似DDL患者中,共有 64 例确诊为DDL患者,其余 24 例均为非DDL患者;多层螺旋CT检查诊断出 63 例DDL患者,其中,59 例DDL与病理诊断一致,20 例非DDL与病理诊断一致,经Kappa一致性检验,Kappa=0.746,P<0.01,2 种诊断方法的一致性一般.病理诊断为DDL的 64 例患者中,有 59 例vimentin表达结果为阳性,5 例为阴性;非DDL的 24 例患者中,6例vimentin表达结果为阳性,18 例为阴性.经Kappa一致性检验,Kappa=0.681,P<0.01,2 种诊断方法的一致性一般;多层螺旋CT联合vimentin表达检测诊断出 63 例DDL患者,其中 61 例DDL与病理诊断一致,22 例非DDL与病理诊断一致,经Kappa一致性检验,Kappa=0.866,P<0.01,2 种诊断方法的一致性较好;多层螺旋CT、vimentin表达检测及联合诊断的敏感度分别为 92.18%,92.18%和 95.31%,特异度分别为 83.34%,75.00%和 91.67%,约登指数分别为 0.755,0.671 和 0.870,联合诊断的价值更高.结论 多层螺旋CT联合vimentin表达检测诊断与病理诊断结果比较一致,可在临床上推广使用.
Abstract
Objective To explore the diagnostic value of multi-slice spiral CT combined with vimentin in dedifferentiated liposarcoma(DDL).Methods A total of 88 patients with suspected DDL admitted to No.904 Hospital of Joint Logistics Support Force of PLA from June 2017 to June 2022 were enrolled.Multi-slice spiral CT examination and vimentin detection were performed in all the patients.Pathological results were taken as the golden standard of diagnosis.The consistency of multi-slice spiral CT examination and pathological results was investigated.The expression of vimentin was compared between DDL patients and non-DDL patients.The diagnostic value of multi-slice spiral CT combined with vimentin in dedifferentiated liposarcoma was analyzed.Results Pathological diagnosis showed that 64 patients were diagnosed as DDL and 24 patients were not DDL.The results of multi-slice spiral CT showed that 63 patients were diagnosed as DDL.CT results of 59 patients with DDL and 20 patients with non-DDL were consistent with pathological diagnosis.The multi-slice spiral CT examination and pathological results were generally consistent(Kappa=0.746,P<0.01).The expression of vimentin was positive in 59 DDL patients and negative in 5 DDL patients.The expression of vimentin was positive in 6 non-DDL patients and negative in 18 non-DDL patients.Kappa consistency test showed that and the 2 diagnostic methods were generally consistent(Kappa=0.681,P<0.01).Sixty-three patients were diagnosed as DDL by multi-slice spiral CT combined with vimentin detection.The combined detection of 61 patients with DDL and 22 patients with non-DDL were consistent with pathological diagnosis.Kappa consistency test showed that,the 2 diagnostic methods were well consistent(Kappa=0.866,P<0.01).The sensitivities of multi-slice spiral CT,vimentin detection and their combination were 92.18% ,92.18% and 95.31% ,respectively;the specificities were 83.34% ,75.00% and 91.67% ,respectively;the Youden indexes were 0.755,0.671 and 0.870,respectively.The combined use of multi-slice spiral CT and vimentin detection had higher diagnostic value for DDL.Conclusion The result of multi-slice spiral CT combined with vimentin detection is consistent with pathological diagnosis and this method can be widely used in clinic.
NETL
NSTL
维普
万方数据