摘要
目的探讨计算机断层摄影(CT)、磁共振成像(MRI)影像表现联合血清正性调节区锌指蛋白-14(PRDM14)和S100钙结合蛋白P(S100P)在胰腺病变性质判断及预后评估价值研究。方法选择2019年1月至2021年6月于内蒙古自治区人民医院行手术切除治疗并经病理证实的82例胰腺肿块患者,所有患者均行CT、MRI检查以及血清PRDM14、S100P检测,根据病理结果分为胰腺癌组(48例)和肿块型胰腺炎组(34例),比较两组间CT、MRI影像表现以及血清PRDM14、S100P的差异,并追踪胰腺癌患者1年内死亡情况,并分为死亡组(18例)和存活组(30例)。通过绘制受试者工作特征(ROC)曲线并计算曲线面积(AUC),分析CT、MRI影像表现联合血清PRDM14和S100P对胰腺癌的诊断价值以及预后评估价值。结果胰腺癌组病灶直径、动脉期及门脉期CT增值、ADC值、病灶存在钙化灶、假性囊肿、胆管穿透征以及右侧肾前筋膜增厚所占比例显著显著低于肿块型胰腺炎组(P<0.05);而胰腺癌组病灶呈分叶征、囊变坏死、DWI呈高信号、胆管与胰管分离征所占比例显著高于肿块型胰腺炎组(P<0.05);两组间胰腺体尾萎缩、胰管扩张、胆管扩张、双管征、胰周血管侵犯以及腹膜后淋巴结肿大所占比例差异均无统计学意义(P>0.05)。胰腺癌组患者血清PRDM14、S100P水平均显著高于肿块型胰腺炎组(P<0.05)。与CT、MRI影像表现、血清PRDM14、S100P水平单独诊断相比较,CT、MRI影像表现联合血清PRDM14、S100P水平诊断胰腺癌的AUC、敏感度、特异度最高。胰腺癌患者死亡组血清PRDM14、S100P水平显著高于存活组(P<0.05)。结论CT、MRI影像表现联合血清PRDM14、S100P水平对胰腺癌的鉴别具有更高的诊断价值,血清PRDM14、S100P水平还可有效评估胰腺癌患者预后情况,有助于进一步为胰腺癌患者的临床诊疗工作提供真实客观的诊断依据并有效评估其预后价值。
Objective To explore the value of computed tomography(CT)and magnetic resonance imaging(MRI)combined with serum positive regulatory region zinc finger protein-14(PRDM14)and S100 calcium binding protein P(S100P)in the evaluation of the nature and prognosis of pancreatic lesions.Methods From January 2019 to June 2021,82 patients with pancreatic masses who underwent surgical resection in People's Hospital of Inner Mongolia Autonomous Region and were confirmed by pathology were selected.All patients underwent CT,MRI and serum PRDM14 and S100P detection.According to the pathological results,they were divided into pancreatic cancer group(48 cases)and mass pancreatitis group(34 cases).The differences of CT and MRI images and serum PRDM14 and S100P between the two groups were compared,and the death of pancreatic cancer patients within one year was followed up,and they were divided into death group(18 cases)and survival group(30 cases).By drawing the receiver operating characteristic(ROC)curve and calculating the area under the curve(AUC),the diagnostic value and prognostic evaluation value of CT and MRI images combined with serum PRDM14 and S100P for pancreatic cancer were analyzed.Results In the pancreatic cancer group,the proportion of lesion diameter,arterial and portal CT increment,ADC value,calcification,pseudocyst,bile duct penetration sign and right anterior renal fascia thickening in the lesion was significantly lower than that in the mass pancreatitis group(P<0.05).The proportion of foci with lobulated sign,cystic necrosis,DWI with high signal,and separation of bile duct and pancreatic duct in pancreatic cancer group was significantly higher than that in mass pancreatitis group(P<0.05).There was no significant difference between the two groups in the proportion of pancreatic body tail atrophy,pancreatic duct expansion,bile duct expansion,double duct sign,peripancreatic vascular invasion and retroperitoneal lymph node enlargement(P>0.05).Serum PRDM14 and S100P levels in patients with pancreatic cancer were significantly higher than those in patients with mass pancreatitis(P<0.05).Compared with CT and MRI imaging manifestations and serum PRDM14 and S100P levels alone for diagnosis,CT and MRI imaging manifestations combined with serum PRDM14 and S100P levels had the highest AUC,sensitivity and specificity in the diagnosis of pancreatic cancer.The levels of serum PRDM14 and S100P in the death group of pancreatic cancer patients were significantly higher than those in the survival group(P<0.05).Conclusion CT and MRI imaging findings combined with serum PRDM14 and S100P levels have higher diagnostic value in the identification of pancreatic cancer.Serum PRDM14 and S100P levels can also effectively evaluate the prognosis of patients with pancreatic cancer,which is helpful to further provide real and objective diagnostic basis for clinical diagnosis and treatment of pancreatic cancer patients and effectively evaluate their prognostic value.
作者
勾少波
王小东
王波
张志强
刘瑞
GOU Shao-bo;WANG Xiao-dong;WANG Bo;ZHANG Zhi-qiang;LIU Rui(Department of Imaging Medicine,People's Hospital of Inner Mongolia Autonomous Region,Hohhot 737399,Inner Mongolia,China;Hepatobiliary Pancreatic Spleen Surgery,People's Hospital of Inner Mongolia Autonomous Region,Hohhot 737399,Inner Mongolia,China;Department of Clinical Laboratory,People's Hospital of Inner Mongolia Autonomous Region,Hohhot 737399,Inner Mongolia,China;Abdominal Tumor Surgery,Inner Mongolia Cancer Hospital,Hohhot 750306,Inner Mongolia,China)
出处
《中国CT和MRI杂志》
2023年第9期125-128,共4页
Chinese Journal of CT and MRI
基金
2019年卫生和计划生育委员会科研计划项目(201902003)。
关键词
计算机断层摄影
磁共振成像
正性调节区锌指蛋白-14
鉴别诊断
S100钙结合蛋白P
胰腺癌
肿块型胰腺炎
预后价值
Computed Tomography
Magnetic Resonance Imaging
Positive Regulatory Region Zinc Finger Protein-14
S100 Calcium Binding Protein P
Pancreatic Cancer
Massive Pancreatitis
Differential Diagnosis
Prognostic Value
