摘要
目的:探讨动态增强磁共振成像(DCE-MRI)定量参数联合糖类抗原15-3(CA15-3)、外周血循环肿瘤细胞(CTC)诊断乳腺癌和预测其预后的价值.方法:选择2018年1月至2020年1月我院收治的95例乳腺癌患者(恶性组)和101例良性乳腺病变患者(良性组).所有患者均接受DCE-MRI检查和血清CA15-3、外周血CTC检测,乳腺癌患者术后随访3年,根据生存情况将患者分为死亡组和存活组.受试者工作特征(ROC)曲线分析DCE-MRI参数和CA15-3、CTC联合诊断乳腺癌和预测乳腺癌预后的价值.结果:恶性组速率常数(Kep)、容积转移常数(Ktrans)、血管外细胞外容积分数(Ve)、血清CA15-3、外周血CTC高于良性组(P＜0.05).随访期间2例失访,死亡45例,存活48例,死亡组Kep、Ktrans、Ve、血清CA15-3、外周血CTC高于存活组(P＜0.05).联合Kep、Ktrans、Ve、血清CA15-3、外周血CTC诊断乳腺癌以及预测乳腺癌预后的曲线下面积为0.865、0.908,均高于单独诊断及预测.结论:乳腺癌患者DCE-MRI参数Kep、Ktrans、Ve值以及血清CA15-3、外周血CTC水平均增加,联合DCE-MRI参数和血清CA15-3、外周血CTC可提高对乳腺癌诊断和预后预测效能.
Abstract
Objective:To investigate the value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)quantita-tive parameters combined with carbohydrate antigen 15-3(CA15-3)and peripheral blood circulating tumor cells(CTC)in the diagnosis and prognosis of breast cancer.Methods:95 breast cancer patients(malignant group)and 101 benign breast lesions patients(benign group)who were admitted to our hospital from January 2018 to January 2020 were selected.All patients underwent DCE-MRI examina-tion and serum CA15-3 and peripheral blood CTC detection,breast cancer patients were followed up for 3 years,patients were divided into death group and survival group according to the survival situation.The value of DCE-MRI parameters combined with CA15-3 and CTC in the diagnosis and prognosis of breast cancer were analyzed by receiver operating characteristic(ROC)curve.Results:The rate constant(Kep),volume transfer constant(Ktrans),extravascular extracellular volume fraction(Ve),serum CA15-3 and peripheral blood CTC in malignant group were higher than those in benign group(P＜0.05).During the follow-up period,2 cases were lost to follow-up,45 cases died and 48 cases survived,Kep,Ktrans,Ve,serum CA15-3 and peripheral blood CTC in death group were higher than those in survival group(P＜0.05).The area under the curve of combined Kep,Ktrans,Ve,serum CA15-3 and peripheral blood CTC in the diagno-sis of breast cancer and the prediction of breast cancer prognosis was 0.865 and 0.908 respectively,which were higher than those of sin-gle diagnosis and prediction.Conclusion:The values of DCE-MRI parameters Kep,Ktrans,Ve,serum CA15-3 and peripheral blood CTC levels are increase in breast cancer patients,the combination of DCE-MRI parameters,serum CA15-3 and peripheral blood CTC can improve the diagnosis and prognosis of breast cancer.
基金项目
内蒙古自治区自然科学基金(2015MSLH0813)
NETL
NSTL
万方数据