多模态MRI结合血清CA125、ZEB1对子宫癌肉瘤与低危型子宫内膜癌的鉴别研究

Differentiation of uterine carcinosarcoma and low-risk endometrial cancer using multimodal MRI combined with serum CA125 and ZEB1

摘要:

目的 分析多模态磁共振成像（MRI）结合血清糖类抗原125（CA125）、E盒结合锌指蛋白1（ZEB1）对子宫癌肉瘤（UCS）与低危型子宫内膜癌（EC）的鉴别价值。方法 回顾性选取2018年1月至2022年12月郑州市金水区总医院收治24例UCS患者和55例低危型EC患者分别作为UCS组和低危型EC组，均行多模态MRI检查和血清CA125、ZEB1检测。以病理结果作为金标准，采用受试者工作特征曲线分析多模态MRI与血清CA125、ZEB1单项及联合对UCS和低危型EC的鉴别价值。结果 UCS组肿瘤最大直径、出血占比、囊变/坏死占比、容积转运常数、血液回流常数均高于低危型EC组（P<0.05），相对表观扩散系数低于低危型EC组（P<0.05）；UCS组血清CA125、ZEB1水平均高于低危型EC组（P<0.05）；多模态MRI联合血清CA125、ZEB1鉴别诊断UCS和低危型EC的灵敏度为95.83%，均高于单项鉴别诊断（P<0.05），联合鉴别诊断的AUC为0.904，均高于单项鉴别诊断，联合鉴别诊断的特异度为74.55%，与单项鉴别诊断比较差异无统计学意义（P>0.05）。结论 多模态MRI和血清CA125、ZEB1均对UCS和低危型EC具有鉴别诊断价值，将三项联合能够进一步提高鉴别诊断价值。

Abstract:

Objective To analyze the differential value of multimodal magnetic resonance imaging (MRI) combined with serum carbohydrate antigen 125 (CA125) and zinc finger E-box binding homeobox 1 (ZEB1) in the diagnosis of uterine carcinosarcoma (UCS) and low-risk endometrial cancer (EC).Method Twenty-four patients with UCS and 55 patients with low-risk EC admitted to Jinshui District General Hospital from January 2018 to December 2022 were retrospectively selected as the UCS group and low-risk EC group, respectively. All patients underwent multimodal MRI examination and serum CA125 and ZEB1 detection. Using pathological results as the gold standard, the discriminant value of multimodal MRI, serum CA125, ZEB1, and their combination for UCS and low-risk EC was analyzed using the reciever operating characteristic curve.Results The maximum tumor diameter, proportion of bleeding, proportion of cystic change/necrosis, volume transport constant and blood reflux constant in the UCS group were higher than those in the low-risk EC group (P<0.05), and the relative apparent diffusion coefficient in the UCS group was lower than that in the low-risk EC group (P<0.05). The serum levels of CA125 and ZEB1 in the UCS group were higher than those in the low-risk EC group (P<0.05). The sensitivity of multimodal MRI combined with serum CA125 and ZEB1 in differential diagnosis of UCS and low-risk EC was 95.83%, which was higher than that of single differential diagnosis (P<0.05). The AUC of combined differential diagnosis was 0.904, which was higher than that of single differential diagnosis. The specificity of combined differential diagnosis was 74.55%, and there was no statistically significant difference compared with single differential diagnosis (P>0.05).Conclusion Multimodal MRI and serum CA125 and ZEB1 have differential diagnostic value for UCS and low-risk EC, and the combination of the three can further improve the differential diagnostic value.