摘要
目的探讨弥散加权成像(DWI)联合血清糖类抗原CA153、CA125及癌胚抗原(CEA)诊断乳腺癌的价值。方法选取2017年11月~2020年11月我院经手术病理或穿刺活检证实存在乳腺肿块98例(98个肿块)女性患者。均行DWI检查并计算表观扩散系数(ADC),同时检测血清CA153、CA125及CEA水平,并以病理结果为“金标准”,计算DWI、肿瘤标志物单独及联合应用鉴别诊断乳腺良、恶性肿块的诊断效能。结果病理检查结果显示98例乳腺肿块中良性肿块(良性组)56个,恶性肿块(恶性组)42个;MRI检查结果显示所有患者DWI均呈高信号,恶性组肿块形状不规则、边缘模糊、毛刺征、MRI强化曲线Ⅱ型或Ⅲ型、淋巴结肿大、血管影增多占比均明显高于良性组(P<0.05);恶性组患者ADC值明显低于良性组,而血清CA153、CA125和CEA水平明显高于良性组(P<0.05);DWI联合血清肿瘤标志物诊断准确恶性结节40个,良性结节51个,与术后病理结果表现出了较好的一致性(Kappa=0.86),明显优于单独诊断;与术后病理检查结果比较,联合诊断敏感度、特异度、阳性预测值、阴性预测值、准确率分别为95.2%、91.1%、88.9%、96.2%、92.9%。结论DWI与肿瘤标志物CA153、CEA、CA125联合在诊断乳腺癌均具有较高的敏感性和特异性,可较为准确地区分乳腺良恶性肿块。
Objective To evaluate the value of diffusion weighted imaging(DWI)combined with serum carbohydrate antigen(CA)153,CA125 and carcinoembryonic antigen(CEA)in the diagnosis of breast cancer.Methods A total of 98 female patients(98 lesions)with breast masses confirmed by surgical pathology or needle biopsy were selected from our hospital from November 2017 to November 2020.DWI examination was performed and apparent diffusion coefficient(ADC)was calculated.At the same time,serum CA153,CA125 and CEA levels were detected.And taking the pathological results as the"gold standard",the diagnostic efficacy of single and combined application of two kinds of DWI and tumor markers in the differential diagnosis of benign and malignant breast masses were calculated.Results Pathological examination showed that there were 56 benign masses and 42 malignant masses among the 98 breast masses.MRI results showed DWI was high signal.The proportion of irregular shape,fuzzy edge,burr sign,MR enhancement curve type II or III,lymphadenopathy and the increased vascular shadow in malignant group was significantly higher than that in benign group(all P<0.05).The ADC value of malignant group was significantly lower than that of benign group,while serum CA153,CA125 and CEA levels were significantly higher than those in benign group(P<0.05).DWI combined with serum tumor markers was accurate in the diagnosis of 40 malignant nodules and 51 benign nodules,showing a good consistency with postoperative pathological results(kappa=0.86),which was significantly better than single diagnosis.Compared with postoperative pathological examination,the sensitivity,specificity,positive predictive val-ue,negative predictive value and accuracy of combined diagnosis were 95.2%,91.1%,88.9%,96.2%and 92.9%respectively.Conclusion DWI combined with tumor markers of CA153,CEA and CA125 has high sensitivity and specificity in the diagnosis of breast cancer,and can accurately distinguish benign and malignant breast masses.
作者
武兵
朱慧
沙德厚
郭依廷
WU Bing;ZHU Hui;SHA Dehou;GUO Yiting(Department of Medical Imaging, Zaozhuang Municipal al Maternal and Child Health Care Hospital, Zaozhuang 277100, P.R.China;Clinical laboratory, Zaozhuang Municipal al Maternal and Child Health Care Hospital, Zaozhuang 277100, P.R.China;Department of Radiology, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250001, P.R.China)
出处
《医学影像学杂志》
2021年第8期1326-1329,1346,共5页
Journal of Medical Imaging
关键词
乳腺癌
磁共振成像
弥散加权成像
糖类抗原153
糖类抗原125
癌胚抗原
Breast cancer
Magnetic resonance imaging
Diffusion weighted imaging
Carbohydrate antigen 153
Carbohydrate antigen 125
Carcinoembryonic antigen
