| 王智宝,崔伟,张微,等.MRI联合血清 CD109、SCCA对乳腺癌及腋窝淋巴结转移的诊断价值[J].安徽医药,2025,29(7):1415-1419. |
| MRI联合血清 CD109、SCCA对乳腺癌及腋窝淋巴结转移的诊断价值 |
| Value of MRI combined with serum CD109 and SCCA in the diagnosis of breast cancer and axillary lymph node metastasis |
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| DOI：10.3969/j.issn.1009-6469.2025.07.030 |
| 中文关键词: 乳腺肿瘤 磁共振成像 白细胞分化抗原 109 鳞状细胞癌抗原 腋窝淋巴结 淋巴转移 |
| 英文关键词: Breast neoplasms Magnetic resonance imaging Cluster of differentiation 109 Squamous cell carcinoma antigen Axillary node Lymphatic metastasis |
| 基金项目:保定市科技计划项目( 2141ZF196) |
| 作者 | 单位 | | 王智宝 | 保定市第二医院, 影像科,河北保定 071051 | | 崔伟 | 保定市第二医院,肿瘤外科,河北保定 071051 | | 张微 | 保定市第二医院,超声科,河北保定 071051 | | 李广现 | 保定市第二医院, 影像科,河北保定 071051 | | 张昕昕 | 保定市第二医院, 影像科,河北保定 071051 |
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| 中文摘要: |
| 目的探究磁共振成像( MRI)联合血清白细胞分化抗原 109(CD109)鳞状细胞癌抗原( SCCA)在乳腺癌诊断、腋窝淋巴结转移诊断中的价值。方法选取河北省保定市第二医院2017年1月至202，1年 12月收治的 87例乳腺癌病人作为研究组，根据有无发生腋窝淋巴结转移将研究组病人分为转移组( 41例)和未转移组( 46例)另选同期该院检查且 74例一般资料与研究组病人相匹配的乳腺良性疾病病人作为对照组，所有病人行 MRI检查。采用受试者，操作特征曲线( ROC曲线)分析并联血清 CD109、SCCA和表观弥散系数( ADC)值对乳腺癌及腋窝淋巴结转移的诊断价值。结果研究组 ADC值低于对照组［(1.15± 0.17)×10.3mm2/s比( 1.41±0.22)×10.3mm2/s］(t=8.45，P<0.05)，且研究组 MRI图像大多呈现出肿瘤形状不规则、肿瘤组织边缘毛刺、强化不均匀以及 TIC曲线类型等特征；研究组血清 CD109和 SCCA表达水平［ 1.27±0.26、(3.55±0.71)μg/L］均高于对照组［1.03±0.02、(2.57±0.59)μg/L］(t=7.92、9.42，P<0.05)；转移组 ADC值低于未转移组( t=2.06，P<0.05)且转移组中肿瘤形状不规则、肿瘤组织边缘毛刺、强化不均匀以及 TIC曲线流出型的病人所占比例较大( P<0.05)；转移组血清，CD109和 SCCA表达水平均高于未转移组( t=3.07、7.17，均 P<0.05)；血清 CD109、SCCA和 ADC值诊断乳腺癌的曲线下面积( AUC)及其 95%CI分别为 0.79(0.71，0.85)、 0.84(0.78，0.90)、 0.86(0.80，0.91)三者联合检测的 AUC及其 95%CI为 0.96(0.91，0.98)优于各自单独诊断(Z三者联合 -CD109=4.54、Z三者联合 -SCCA=4.17、Z三者联合 -ADC值=3.74，，均 P<0.001)；血清 CD109、SCCA和 ADC值诊断腋窝淋巴，结转移的 AUC及其 95%CI分别为 0.65(0.54，0.74)0.78(0.67，0.86)、 0.70(0.59，0.79)，三者并联联合诊断的 AUC及其 95%CI为 0.87(0.78，0.94)，优于各自单独诊断( Z三者联合 -CD109=4.2、5、Z三者联合 -SCCA=3.54、Z三者联合 -ADC值=3.18，均 P<0.001)。结论研究组与对照组、淋巴结转移组 |
| 英文摘要: |
| Objective To explore the value of magnetic resonance imaging (MRI) combined with serum leukocyte differentiation anti-gen 109 (CD109) and squamous cell carcinoma antigen (SCCA) in the diagnosis of breast cancer and axillary lymph node metastasis.Methods Eighty-seven patients with breast cancer accepted by Hebei Baoding Second Hospital from January 2017 to December2021 were collected as the test group and assigned into a metastatic group (41 cases) and a non metastatic group (46 cases) based onthe occurrence of axillary lymph node metastasis, while 74 patients with benign breast diseases who were examined in the same hospitaland matched with the test group were included as reference group. The diagnostic value of CD109, SCCA and apparent diffusion coeffi-cient (ADC) in parallel serum for breast cancer and axillary lymph node metastasis was analyzed by receiver operating characteristic(ROC) curve.Results The ADC value of the study group was lower than that of the control group [(1.15±0.17)×10.3 mm2/s vs. (1.41± 0.22)×10.3 mm2/s, t=8.45, P<0.05], and the MRI images of the study group mostly showed irregular tumor shape, spiculated tumor tissueedges, uneven enhancement, and TIC curve types. The expression levels of serum CD109 and SCCA [1.27±0.26, (3.55±0.71) μg/L] inthe study group were higher than those in the control group [1.03±0.02, (2.57±0.59) μg/L] (t=7.92, 9.42, P<0.05). The ADC value of the metastatic group was lower than that of the non metastatic group (t=2.06, P<0.05), and the proportion of patients with irregular tumorshape, rough tumor tissue edges, uneven enhancement, and TIC curve outflow type was higher in the metastatic group (P<0.05). The ex-pression levels of serum CD109 and SCCA in the metastatic group were higher than those in the non metastatic group (t=3.07, 7.17, P< 0.05); the AUC of CD109, SCCA and ADC in serum for diagnosis of breast cancer were 0.79 (0.71, 0.85), 0.84 (0.78, 0.90), 0.86 (0.80, 0.91), respectively. The AUC for three parallel joint detection was 0.96 (0.91, 0.98), which was superior to their separate diagnosis (Zcom-bined-CD109=4.54, Zcombined-SCCA=4.17, Zcombined-ADC value=3.74, all P<0.001). The AUC values of serum CD109, SCCA, and ADC for diagnosing axil-lary lymph node metastasis were 0.65 (0.54, 0.74), 0.78 (0.67, 0.86), and 0.70 (0.59, 0.79), respectively. The AUC for three paralleljoint detection was 0.87 (0.79, 0.94), which was superior to their individual diagnosis (Zcombination-CD109=4.25, Zcombination-SCC=3.54, Zcombina-tion-ADC value=3.18, average P<0.001).Conclusions There are significant differences in MRI images between the study group and the con-trol group, lymph node metastasis group and non metastasis group. MRI combined with serum CD109 and SCCA has high auxiliary di-agnostic value for breast cancer and axillary lymph node metastasis. |
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