摘要
目的探讨磁共振动态对比增强(DCE-MRI)联合微小核糖核酸-21(miR-21)、miR-92a在骨肿瘤良恶性鉴别及疗效评估中的应用价值。方法回顾性选取广州市番禺区中医院2018年6月至2019年6月收治的120例骨肿瘤患者,其中良性组52例,恶性组68例。对比两组DCE-MRI动态强化参数及肿瘤组织miR-21、miR-92a水平,分析DCE-MRI、miR-21、miR-92a联合诊断价值及三者之间相关性。对骨恶性肿瘤患者予以综合治疗,术后6个月,根据实体肿瘤疗效判定标准分为疗效良好、疗效不佳,对比不同疗效患者DCE-MRI动态强化参数[信号增强幅度(SEE)、早期动态增强斜率值(Slope)、向心性增强率(DER)]及肿瘤组织miR-21、miR-92a水平。结果恶性组SEE、Slope、DER及miR-21、miR-92a水平均高于良性组(P<0.05);DCE-MRI、miR-21、miR-92a联合诊断骨肿瘤良恶性的曲线下面积(AUC)(0.885)>Slope(0.818)>SEE(0.788)>miR-21(0.785)>miR-92a(0.740)>DER(0.660),灵敏度为80.88%,特异度为88.46%;DCE-MRI动态强化参数SEE、Slope、DER与miR-21、miR-92a均呈正相关(P<0.05);疗效良好骨恶性肿瘤患者DCE-MRI动态强化参数SEE、Slope、DER及miR-21、miR-92a均低于疗效不佳患者(P<0.05)。结论DCE-MRI动态强化参数、miR-21、miR-92a水平在骨恶性肿瘤患者中呈异常高表达状态,联合检测有助于鉴别骨肿瘤良恶性、评估疗效。
Objective To investigate the application value of magnetic resonance dynamic contrast enhancement magnetic resonance imaging(DCE-MRI)combined with microRNA-21(miR-21)and miR-92a in the benign and malignant differentiation of bone tumors and the evaluation of their efficacy.Methods A total of 120 patients with bone tumors were selected retrospectively from June 2018 to June 2019 in Panyu Hospital of Chinese Medicine,including 52 cases in the benign group and 68 cases in the malignant group.The DCE-MRI dynamic enhancement parameters and tumor tissue miR-21,miR-92a levels were compared between the two groups.The diagnostic value of DCE-MRI,miR-21,miR-92a levels of cancer tissue and their correlation were analyzed.Patients with bone malignant tumors were given comprehensive treatment.Six months after operation,according to the criteria of solid tumor curative effect,they were divided into good curative effect group and poor curative effect group.The DCE-MRI dynamic enhancement parameters[signal enhancement amplitude(SEE),early dynamic enhancement slope value(Slope),centripetal enhancement rate(DER)],miR-21,miR-92a levels of patients with different curative effects were compared.Results The levels of SEE,Slope,DER and miR-21 a nd miR-92a in the malignant group were higher than those in the benign group(P<0.05);The area under curve(AUC)of DCE-MRI,miR-21,miR-92a combined in the diagnosis of benign and malignant bone tumors(0.885)>Slope(0.808)>SEE(0.788)>miR-21(0.785)>miR-92a(0.740)>DER(0.660),with sensitivity 80.88%,specificity 88.46%,respectively;the DCE-MRI dynamic enhancement parameters SEE,Slope,DER were positively correlated with miR-21 and miR-92a(P<0.05);the DCE-MRI dynamic enhancement parameters SEE,Slope,DER and miR-21,miR-92a of patients with good curative effect were lower than those with poor curative effect(P<0.05).Conclusions DCE-MRI dynamic enhancement parameters,miR-21,miR-92a levels are abnormally high expression in patients with bone malignant tumors,and combined detection is expected to become an important means to identify benign and malignant bone tumors and evaluate the efficacy.
作者
徐秋妍
何建灵
黄庆艳
Xu Qiuyan;He Jianling;Huang Qingyan(Department of Medical Imaging,Panyu Hospital of Chinese Medicine,Guangzhou 511400,China;Department of Orthopedics,Panyu Hospital of Chinese Medicine,Guangzhou 511400,China)
出处
《中国医师杂志》
CAS
2021年第4期548-552,共5页
Journal of Chinese Physician
