Application of dynamic contrast-enhanced magnetic resonance imaging combined with serum microRNA-486-5p in the diagnosis of pancreatic cancer and evaluation of surgical resectability
Objective To explore the value of dynamic contrast-enhanced magnetic resonance ima-ging(DCE-MRI)combined with serum microRNA(miR)-486-5 p in the diagnosis of pancreatic cancer and evaluation of surgical resectability.Methods Totally,136 patients with pancreatic space-occupying lesions admitted to Yantaishan Hospital,Yantai City from June 2019 to June 2023 were selected as the study sub-jects.All patients received DCE-MRI scanning and serum miR-486-5p detection.Surgical pathology was used as the diagnostic gold standard and actual surgical resection was taken as the surgical resectability stand-ard,and the value of DCE-MRI,serum miR-486-5p and the combination of the two in the diagnosis of pan-creatic cancer and in the evaluation of surgical resectability was evaluated by diagnostic test fourfold table.Mann-Whitney U test and chi-square test were used for comparison between groups.Results Among 136 patients,98 cases of pancreatic cancer(pancreatic cancer group)and 38 cases of non-pancreatic cancer(benign lesion group)were confirmed by pathological diagnosis.The expression level of serum miR-486-5p in pancreatic cancer group was 3.48(1.41-7.64),which was significantly higher than 1.02(0.36-1.58)in be-nign lesion group(Z=3.162,P＜0.05).The sensitivity,specificity,accuracy and consistency Kappa val-ue with pathological diagnosis in the diagnosis of pancreatic cancer were 97.95％(96/98),81.58％(31/38),93.38％(127/136)and 0.829 of DCE-MRI combined with serum miR-486-5p,respectively.Among 98 patients with pancreatic cancer,35 cases(resectable group)actually underwent surgical resec-tion and 63 cases could not be resected(unresectable group).The expression level of miR-486-5p was 2.05(1.01-3.72)in resectable group,which was significantly lower than 4.88(2.95-10.01)in unresect-able group(Z=3.882,P＜0.05).The sensitivity,specificity,accuracy and consistency Kappa value with actual surgical resection of DCE-MRI combined with serum miR-486-5p in predicting resectable pan-creatic cancer were 77.14％(27/35),100.00％(63/63),91.84％(90/98)and 0.813 respectively.Conclusion Both DCE-MRI and serum miR-486-5p can enhance the sensitivity and accuracy of pancreat-ic cancer diagnosis,and the predicted surgical resectability has higher consistency with actual surgical resection.
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