磁共振弥散加权成像ADC值联合血清肿瘤标志物对结直肠癌患者术后复发转移的预测价值

doi:10.3969/j.issn.1006-6233.2024.07.021

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摘要 目的: 分析磁共振扩散加权成像(MRI-DWI)表观弥散系数(ADC)值联合血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原199(CAl99)、糖类抗原724(CA724)]对结直肠癌患者术后复发转移的预测价值。方法: 选择2020年1月至2022年1月于本院接受根治性切除术治疗的80例结直肠癌患者患者纳入病例组,另选同期在本院接受结直肠癌筛查且排除结直肠癌的80例健康者纳入健康组。两组均接受MRI-DWI检查及血清学检查,对比两组ADC值及血清肿瘤标志物水平。病例组患者术后随访,根据术后是否复发将患者分为发生组与未发生组,对比两组一般资料、ADC值及血清肿瘤标志物水平,经线性回归分析上述指标与复发转移的相关性,绘制ROC曲线分析预测价值。结果: 与对照组相比,病例组ADC值,血清CEA、CAl99、CA724水平高(P<0.05);经根治性切除术治疗后发现,病例组15例发生复发转移,占比18.75%;发生组ADC值低于未发生组,血清肿瘤标志物水平均高于未发生组(P<0.05),其余临床资料相比未见明显差异(P>0.05);经线性回归分析显示,ADC值、血清肿瘤标志物水平与术后复发转移的关系密切(P<0.05);绘制ROC曲线后,CEA、CA199、CA724、ADC值分别预测术后复发转移的AUC为0.813、0.815、0.755、0.838,联合预测AUC为0.907。结论: 结直肠癌术后复发转移患者ADC值呈低表达,血清肿瘤标志物水平呈高表达,上述指标表达与结直肠癌患者术后复发转移关系密切有关,且联合检测可有效提高预测结直肠癌患者术后复发转移的价值。

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关键词 ：结直肠癌, 根治性切除术, 磁共振弥散加权成像, 表观弥散系数值, 肿瘤标志物, 复发转移

Abstract：Objective: To investigate the predictive value of magnetic resonance diffusion-weighted imaging (MRI-DWI) apparent diffusion coefficient (ADC) combined with serum tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), carbohydrate antigen 724 (CA724)] for postoperative recurrence and metastasis in patients with colorectal cancer. Methods: Eighty patients with colorectal cancer who underwent radical resection in our hospital from January 2020 to January 2022 were enrolled in the case group. Another 80 healthy subjects who underwent colorectal cancer screening and were excluded from colorectal cancer in our hospital during the same period were enrolled in the control group. Both groups underwent MRI-DWI and serum examination, and the ADC values and serum tumor marker levels of the two groups were compared. The patients in the case group were followed up after surgery, and the patients were divided into the recurrence group and the non-recurrence group according to whether they recurred after surgery. The general data, ADC values, and serum tumor marker levels of the two groups were compared. The correlation between the above indicators and recurrence and metastasis was analyzed by linear regression analysis, and ROC curves were drawn to analyze the predictive value. Results: Compared with the control group, the ADC values and serum CEA, CA199, and CA724 levels in the case group were higher (P<0.05). After radical resection, 15 cases of recurrence and metastasis were found in the case group, accounting for 18.75%. The ADC values in the recurrence group were lower than those in the non-recurrence group, and the serum tumor marker levels were all higher than those in the non-recurrence group (P<0.05). There were no significant differences in the remaining clinical data (P>0.05). Linear regression analysis showed that the ADC value and serum tumor marker level were closely related to postoperative recurrence and metastasis (P<0.05). After drawing the ROC curve, the AUC values of CEA, CA199, CA724, and ADC for predicting postoperative recurrence and metastasis were 0.813, 0.815, 0.755, and 0.838, respectively. The AUC of the joint prediction was 0.907. Conclusion: The ADC value of patients with postoperative recurrence and metastasis of colorectal cancer is low, and the serum tumor marker level is high. The expression of these indicators is closely related to the postoperative recurrence and metastasis of patients with colorectal cancer. Joint detection can effectively improve the value of predicting postoperative recurrence and metastasis in patients with colorectal cancer.

Key words： Colorectal cancer Radical resection Magnetic resonance diffusion-weighted imaging Apparent diffusion coefficient Tumor markers Recurrence and metastasis

基金资助:江苏省优势学科建设工程项目,(编号:YGPS2029-087)

通讯作者: 张艳

引用本文:

姚均, 瞿献莉, 梁佳月, 张艳. 磁共振弥散加权成像ADC值联合血清肿瘤标志物对结直肠癌患者术后复发转移的预测价值[J]. 河北医学, 2024, 30(7): 1171-1176.
YAO Jun, et al. Predictive Value of Magnetic Resonance Diffusion-Weighted Imaging Apparent Diffusion Coefficient Combined with Serum Tumor Markers for Postoperative Recurrence and Metastasis in Patients with Colorectal Cancer. HeBei Med, 2024, 30(7): 1171-1176.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.07.021 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I7/1171

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