多层螺旋CT联合糖类抗原125、甲胎蛋白在直肠癌术前淋巴结分期中的应用价值
Application value of multi-slice spiral CT combined with carbohydrate antigen 125 and alpha fetoprotein in preoperative lymph node staging of rectal cancer
骆科纯 1包军军1
作者信息
- 1. 海安市中医院放射科,南通 226600
- 折叠
摘要
目的 探讨多层螺旋CT联合糖类抗原125(CA125)及甲胎蛋白(AFP)在直肠癌术前淋巴结分期中的应用价值.方法 回顾性病例系列研究.回顾性分析2020年8月至2022年8月海安市中医院手术后经病理检查证实的90例直肠癌患者临床资料,分析多层螺旋CT判断术前N分期与病理N分期的诊断符合率.比较不同病理N分期(N0期、N1期、N2期)患者的血清CA125及AFP水平.以术后病理结果为金标准,采用logistic回归分析多层螺旋CT、CA125和AFP与直肠癌淋巴结转移的相关性,并构建受试者工作特征(ROC)曲线,评价多层螺旋CT联合CA125、AFP对直肠癌淋巴结转移的诊断效能.结果 病理分期结果显示,N0期44例,N1期33例,N2期13例;多层螺旋CT分期结果显示,N.期49例,N,期26例,N2期15例.病理分期和多层螺旋CT分期一致的N0、N,、N2期分别为34、15、5例.病理分期N0、N1、N2期组血清 CA125 水平分别为(15.8±1.4)U/ml、(38.9±2.4)U/ml、(85.4±3.3)U/ml,差异有统计学意义(F=5 519.47,P＜0.05);AFP水平分别为(37.8±2.5)ng/ml、(79.3±4.6)ng/ml、(168.3±5.9)ng/ml,差异有统计学意义(F=5 583.80,P＜0.05).logistic回归分析显示,多层螺旋CT N分期(OR=6.231,95％CI:2.164～17.939,P=0.001)、AFP(OR=1.020,95％CI:1.002～1.039,P=0.032)是直肠癌患者淋巴结转移的独立影响因素.ROC曲线分析显示,AFP、CA125、多层螺旋CT及三者联合诊断淋巴结转移的曲线下面积分别为0.850、0.731、0.745及0.912.结论 多层螺旋CT联合血清CA125、AFP在直肠癌术前淋巴结分期中具有较高的应用价值.
Abstract
Objective To explore the application value of multi-slice spiral CT combined with carbohydrate antigen 125(CA125)and alpha fetoprotein(AFP)in preoperative lymph node staging of rectal cancer.Methods A retrospective case series study was performed.The clinical data of 90 patients with rectal cancer confirmed by pathology after operation at Haian Traditional Chinese Medicine Hospital from August 2020 to August 2022 were retrospectively analyzed.Multi-slice spiral CT was used to judge the diagnostic consistency between preoperative N stage and pathological N stage.The levels of serum CA125 and AFP in patients with different pathological N stages(N0 stage,N1 stage,N2 stage)were compared.Taking postoperative pathological results as the gold standard,logistic regression was used to analyze the correlation between multi-slice spiral CT,CA125,and AFP with lymph node metastasis in rectal cancer.The receiver operating characteristic(ROC)curve was constructed to evaluate the diagnostic efficacy of multi-slice spiral CT combined with CA125 and AFP for lymph node metastasis.Results The pathological staging results showed that there were 44 cases in N0 stage,33 cases in N1 stage,and 13 cases in N2 stage.Multi-slice spiral CT staging results showed that there were 49 cases in N0 stage,26 cases in N1 stage,and 15 cases in N2 stage.The consistency between pathological staging and multi-slice spiral CT staging occurred in 34 cases in N0 stage,15 cases in N1 stage and 5 cases in N2 stage.The serum CA125 level in the pathological N0,N1,and N2 stages groups was(15.8±1.4)U/ml,(38.9±2.4)U/ml,and(85.4±3.3)U/ml,respectively,and the difference was statistically significant(F=5 519.47,P＜0.05).The AFP level was(37.8±2.5)ng/ml,(79.3±4.6)ng/ml,and(168.3±5.9)ng/ml,respectively,and the difference was statistically significant(F=5 583.80,P＜0.05).Logistic regression analysis showed that N staging(OR=6.231,95％CI:2.164-17.939,P=0.001)and AFP(OR=1.020,95％CI:1.002-1.039,P=0.032)were independent factors influencing the metastasis of lymph node in rectal cancer patients.ROC curve analysis showed that the area under the curve of AFP,CA125,multi-slice spiral CT,and the combination of the 3 in the diagnosis of lymph node metastasis was 0.850,0.731,0.745,and 0.912,respectively.Conclusions Multi-slice spiral CT combined with serum CA125 and AFP has a high value in the diagnosis of preoperative lymph node staging of rectal cancer.
关键词
直肠肿瘤/多层螺旋CT/糖类抗原125/甲胎蛋白/淋巴结转移/诊断Key words
Rectal neoplasms/Multi-slice spiral CT/Carbohydrate antigen 125/Alpha fetoprotein/Lymph node metastasis/Diagnosis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据