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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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

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

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