MRI联合血清SCCA、CA125对宫颈癌的诊断意义

目的探讨磁共振成像(MRI)联合血清标志物诊断宫颈癌宫旁浸润与盆腔淋巴结转移的临床价值。方法回顾性分析96例宫颈癌患者临床资料,以术中病理学检测结果为"金标准",根据其宫旁浸润情况分为浸润组(n=27)与非浸润组(n=69),根据其盆腔淋巴结转移情况分为转移组(n=21)与非转移组(n=75),单因素比较对应两组MRI诊断阳性率及血清标志物鳞状细胞癌抗原(SCCA)、糖类抗原125(CA125)]水平差异,通过受试者工作特征(ROC)曲线描述各指标及联合方案诊断效能。结果浸润组与转移组MRI阳性率及血清SCCA、CA125水平分别明显高于非浸润组与非转移组(P<0.05)。ROC曲线显示,MRI联合血清SCCA、CA125诊断宫颈癌宫旁浸润曲线下面积(AUC)为0.748(95%CI=0.614~0.881),灵敏度与特异度分别为62.96%、89.86%;诊断宫颈癌盆腔淋巴结转移A U C为0.824(95%CI=0.703~0.945),灵敏度与特异度分别为71.43%、88.00%。结论 MRI联合血清SCCA、CA125可较为准确识别宫颈癌宫旁浸润与盆腔淋巴结转移情况,能为治疗前评估及预后预测提供全面而可靠的临床证据。

Diagnostic Significance of MRI Combined with Serum SCCA and CA125 for Cervical Cancer

Objective To explore the clinical value of magnetic resonance imaging(MRI) combined with serum markers in the diagnosis of cervical cancer parametrial infiltration and pelvic lymph node metastasis. Methods The clinical data of 96 patients with cervical cancer were retrospectively analyzed, and the results of intraoperative pathological examination were gold standards. According to their parametrial infiltration, they were divided into infiltration group(n=27) and non-infiltration group(n=69). According to their pelvic lymph node metastasis, they were divided into metastasis group(n=21) and non-metastasis group(n=75). Univariate comparison was used to compare the positive rate of MRI diagnosis and serum markers levels squamous cell carcinoma antigen(SCCA), carbohydrate antigen 125(CA125)], and the diagnostic efficacy of each indicator and combined regimen was described by receiver operating characteristic(ROC) curve. Results The positive rate of MRI and serum SCCA and CA125 levels in infiltration group and metastasis group were significantly higher than those in non-invasion group and nonmetastasis group(P<0.05). The ROC curve showed that the area under the curve(AUC) of MRI combined with serum SCCA and CA125 was 0.748(95% CI=0.614~0.881) in the diagnosis of cervical cancer parametrial infiltration, and the sensitivity and specificity were 62.96% and 89.86% respectively. The AUC was 0.824(95% CI=0.703~0.945) in the diagnosis of cervical cancer pelvic lymph node metastasis, and the sensitivity and specificity were 71.43% and 88.00% respectively. Conclusion MRI combined with serum SCCA and CA125 can accurately identify paracranial infiltration and pelvic lymph node metastasis of cervical cancer, and provide comprehensive and reliable clinical evidence for pre-treatment assessment and prognosis prediction.