摘要
目的探讨磁共振动态增强(DCE-MRI)结合血循环肿瘤细胞(CTCs)、循环游离DNA(cfDNA)对乳腺癌的诊断价值。方法选取沧州市人民医院2020年6月至2021年11月符合纳入标准的乳腺癌病人82例(乳腺癌组)。另选同期65例乳腺良性病变且未合并其他疾病者作为良性组。比较两组DCE-MRI定量参数、CTCs、cfDNA水平,对比MRI特征,分析DCE-MRI结合CTCs、cfDNA诊断乳腺癌的价值。结果乳腺癌组DCE-MRI定量参数速度常数(K^(trans))值、速率常数(K_(ep))值、Alu247/115水平及CTCs计数分别为(0.18±0.04)min、(1.32±0.27)min、(12.97±2.14)个/毫升、0.97±0.32,比良性组高(0.05±0.01)min、(0.51±0.11)min、(10.15±1.45)个/毫升、0.55±0.12(P<0.05)。良性组边缘多光滑,形状规则,内部强化以均匀为主,时间-信号强度曲线(TIC)以Ⅰ型多见,早期增强率<60%;乳腺癌组边缘毛刺征、形状不规则,内部不均匀强化为主,以TIC分型Ⅲ型多见,早期增强率<60%占比高。两组MRI形态表现比较差异有统计学意义(P<0.05)。淋巴结转移、Ⅲ~Ⅳ期者CTCs数量、Alu247/115水平明显高于无淋巴结转移、Ⅰ~Ⅱ期者(P<0.05)。受试者操作特征(ROC)曲线分析结果显示,三者联合(DCE-MRI+CTCs+cfDNA)诊断乳腺癌的曲线下面积(AUC)、灵敏度、特异度分别为0.86、0.93、0.84,诊断效果优于单一检测CTCs、cfDNA检测(P<0.05)。结论乳腺癌病人CTCs、cfDNA存在异常表达,可能与病人临床分期、淋巴结转移有关,相对单一实验室检测,DCE-MRI结合CTCs、cfDNA检测能获取更多可靠信息。
Objective To investigate the diagnostic value of dynamic magnetic resonance enhancement(DCE-MRI)combined with cir-culating tumor cells(CTCs)and circulating cell-free DNA(cfDNA)in breast cancer.Methods A total of 82 patients with breast cancer who met the inclusion criteria in Cangzhou People's Hospital from June 2020 to November 2021 were selected as the breast cancer group.Another 65 cases of benign breast lesions without other diseases were selected as the benign group during the same period.The quantitative parameters of DCE-MRI,the levels of CTCs and cfDNA,and the characteristics of MRI were compared between the two groups.The diagnostic value of DCE-MRI combined with CTCs and cfDNA in breast cancer was analyzed.Results The levels of Ktrans,Kep,Alu247/115 and CTCs in breast cancer group were(0.18±0.04)min,(1.32±0.27)min,(12.97±2.14)cells/mL and 0.97±0.32,respectively.They were higher than those in benign group[(0.05±0.01)min,(0.51±0.11)min,(10.15±1.45)cells/mL,0.55±0.12](P<0.05).In benign group,the edges were smooth,the shape was regular,the internal enhancement was mainly uniform,and the time sig-nal intensity curve(TIC)was mostly typeⅠ,with the early enhancement rate<60%.In the breast cancer group,the edge burr sign,irreg-ular shape,and internal uneven enhancement were mainly found,and the TIC typeⅢwas more common,and the early enhancement rate was less than 60%.There was significant difference in MRI morphology between the two groups(P<0.05).The number of CTCs and the level of Alu247/115 in patients with lymph node metastasis and stageⅢ-Ⅳwere significantly higher than those without lymph node metastasis and stage I-Ⅱ(P<0.05).The receiver operating characteristic(ROC)curve analysis results showed that the area under the curve(AUC),sensitivity and specificity of the combination of DCE-MRI+CTCs+cfDNA in the diagnosis of breast cancer were 0.86,0.93 and 0.84,respectively,and the diagnostic effect was better than that of the single detection of CTCs and cfDNA(P<0.05).Conclusion The abnormal ex
作者
张倩
俱京涛
张雅琼
张春谦
ZHANG Qian;JU Jingtao;ZHANG Yaqiong;ZHANG Chunqian(MRI Room,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China;Fangshan Hospital Beijing University of Chinese Medicine,Beijing 102400,China;Radiology Department,Shijia-zhuang Third Hospital,Shijiazhuang,Hebei 050000,China;CT Room,Cangzhou Central Hospi-tal,Cangzhou,Hebei 061000,China)
出处
《安徽医药》
CAS
2024年第4期732-736,I0003,共6页
Anhui Medical and Pharmaceutical Journal
基金
沧州市重点研发计划指导项目(213106021)。
关键词
乳腺肿瘤
肿瘤细胞
循环
磁共振成像
循环游离DNA
诊断价值
Breast neoplasms
Neoplastic cells,circulating
Magnetic resonance imaging
Circulating cell-free DNA
Diagnos-tic value
