| 张倩,俱京涛,张雅琼,等.磁共振动态增强结合血循环肿瘤细胞、循环游离 DNA对乳腺癌的临床诊断研究[J].安徽医药,2024,28(4):732-736. |
| 磁共振动态增强结合血循环肿瘤细胞、循环游离 DNA对乳腺癌的临床诊断研究 |
| Dynamic contrast-enhanced magnetic resonance imaging combined with circulating tumor cells and circulating cell-free DNA in the clinical diagnosis of breast cancer |
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| DOI：10.3969/j.issn.1009-6469.2024.04.020 |
| 中文关键词: 乳腺肿瘤 肿瘤细胞，循环 磁共振成像 循环游离 DNA 诊断价值 |
| 英文关键词: Breast neoplasms Neoplastic cells, circulating Magnetic resonance imaging Circulating cell-free DNA Diagnos?tic value |
| 基金项目:沧州市重点研发计划指导项目( 213106021) |
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| 中文摘要: |
| 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( Ktrans)值、速率常数( Kep)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< |
| 英文摘要: |
| 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 cancerwho met the inclusion criteria in Cangzhou People's Hospital from June 2020 to November 2021 were selected as the breast cancergroup. Another 65 cases of benign breast lesions without other diseases were selected as the benign group during the same period. Thequantitative parameters of DCE-MRI, the levels of CTCs and cfDNA, and the characteristics of MRI were compared between the twogroups. 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 type Ⅰ, 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 type Ⅲ was more common, and the early enhancementrate 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 stage Ⅲ-Ⅳ were 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 thecurve (AUC), sensitivity and specificity of the combination of DCE-MRI+CTCs+cfDNA in the diagnosis of breast cancer were 0.86, 0.93and 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 expression of CTCs and cfDNA in breast cancer patients may be related to the clinical stage and lymph node metastasis.Compared with single laboratory detection, DCE-MRI combined with CTCs and cfDNA detection can obtain more reliable information. |
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