| 卞梦涔,张 佳,尹 娜,唐 艳,黄 旭.多层螺旋CT联合血清糖类抗原19-9、细胞角蛋白19片段抗原、Dickkopf-1蛋白诊断食管癌的临床价值研究[J].,2023,(2):277-282 |
| 多层螺旋CT联合血清糖类抗原19-9、细胞角蛋白19片段抗原、Dickkopf-1蛋白诊断食管癌的临床价值研究 |
| Clinical Value Study of Multi-Slice Spiral CT Combined with Serum Carbohydrate Antigen 19-9, Cytokeratin 19 Fragment Antigen and Dickkopf-1 Protein in the Diagnosis of Esophageal Cancer |
| 投稿时间：2022-06-30 修订日期：2022-07-26 |
| DOI：10.13241/j.cnki.pmb.2023.02.014 |
| 中文关键词: 食管癌 多层螺旋CT 糖类抗原19-9 细胞角蛋白19片段抗原 Dickkopf-1蛋白 |
| 英文关键词: Esophageal cancer Multi-slice spiral CT Carbohydrate antigen 19-9 Cytokeratin 19 fragment antigen Dickkopf-1 protein |
| 基金项目:江苏省卫生健康委科研项目（BJ19032）；江苏省肿瘤医院院级科研课题（ZN201610） |
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| 中文摘要: |
| 摘要 目的：研究多层螺旋CT（MSCT）联合血清糖类抗原19-9（CA19-9）、细胞角蛋白19片段抗原（CYFRA21-1）、Dickkopf-1蛋白诊断食管癌的临床价值。方法：选择2018年1月～2021年12月江苏省肿瘤医院收治的102例疑似食管癌患者。根据手术病理结果分为恶性组58例以及良性组44例，对所有受试者均进行MSCT扫描，比较两组各项MSCT影像学特征。检测并比较两组血清CA19-9、CYFRA21-1以及Dickkopf-1表达水平。通过Logistic回归建立多指标联合应用的风险预测模型，应用受试者工作特征（ROC）曲线分析MSCT联合血清CA19-9、CYFRA21-1以及Dickkopf-1蛋白诊断食管癌的效能。结果：恶性组MSCT特征表现为形态不规则、边界模糊病例数占比均高于良性组（均P＜0.05）。关联性检验P＜0.05，提示MSCT诊断方法和金标准病理方法显著关联；优势性检验P＞0.05，提示MSCT诊断方法和金标准病理方法优势差异不显著，即MSCT诊断方法是一种较有价值的食管癌诊断方法。恶性组血清CA19-9、CYFRA21-1以及Dickkopf-1表达水平均高于良性组（均P＜0.05）。经ROC曲线分析发现：MSCT联合血清CA19-9、CYFRA21-1以及Dickkopf-1诊断食管癌的曲线下面积（0.863）、灵敏度（0.879）、特异度（0.841）以及约登指数（0.720）均高于MSCT、血清CA19-9、CYFRA21-1以及Dickkopf-1诊断。结论：MSCT联合血清CA19-9、CYFRA21-1以及Dickkopf-1蛋白诊断食管癌的临床价值较高，值得推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To study the clinical value of multi-slice spiral CT (MSCT) combined with serum carbohydrate antigen 19-9 (CA19-9), cytokeratin 19 fragment antigen (CYFRA21-1) and Dickkopf-1 protein in the diagnosis of esophageal cancer. Methods: 102 suspected esophageal cancer patients who were admitted to the Jiangsu Cancer Hospital from January 2018 to December 2021 were selected. According to the surgical and pathological results, they were divided into malignant group with 58 cases and benign group with 44 cases. All subjects were scanned with MSCT, and the MSCT imaging characteristics of the two groups were compared. The expression levels of serum CA19-9, CYFRA21-1 and Dickkopf-1 were detected and compared between the two groups. A risk prediction model for the combined use of multiple indicators was developed by logistic regression, The efficacy of MSCT combined with serum CA19-9, CYFRA21-1 and Dickkopf-1 proteins in the diagnosis of esophageal cancer was analyzed by receiver operating characteristic (ROC) curve. Results: The proportion of number of cases with MSCT features with irregular shape and fuzzy boundary in the malignant group was higher than those in the benign group (all P＜0.05). Association test P<0.05, indicating that the diagnostic method of MSCT and the gold standard pathological method were significantly associated; The superiority test P>0.05 indicated that there was no significant difference between the advantages of MSCT diagnostic methods and gold standard pathological methods, MSCT diagnostic method is a more valuable diagnostic method for esophageal cancer. The expression levels of serum CA19-9, CYFRA21-1 and Dickkopf-1 in malignant group were higher than those in benign group (all P＜0.05). The ROC curve analysis showed that the area under the curve (0.863), sensitivity (0.879), specificity (0.841) and yoden index (0.720) of MSCT combined with Serum CA19-9, CYFRA21-1 and Dickkopf-1 in diagnosing esophageal cancer were higher than those of MSCT, Serum CA19-9, CYFRA21-1 and Dickkopf-1. Conclusion: MSCT combined with serum CA19-9, CYFRA21-1 and Dickkopf-1 protein has high clinical value in the diagnosis of esophageal cancer, which is worth popularizing. |
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