标题：DCE-MRI、DWI联合血清c-Met、MACC1对宫颈癌盆腔淋巴结转移的诊断价值

      作者：李振玉 1，牛永超 2，闫少华 2，万晓旻 1    李振玉 1，牛永超 2，闫少华 2，万晓旻 11.新乡市传染病医院影像科，河南 新乡 453000；2.新乡市中心医院影像科，河南 新乡 453000

      卷次： 2023年34卷23期

      【摘要】 目的 探讨磁共振动态增强扫描成像(DCE-MRI)、磁共振弥散加权成像(DWI)联合血清人原癌基因编码蛋白(c-Met)、结肠癌转移相关基因1 (MACC1)对宫颈癌盆腔淋巴结转移的诊断价值。方法 回顾性分析2021年1月至2022年12月在新乡市中心医院诊治的100例宫颈癌患者的临床资料，按照是否出现盆腔淋巴结转移将患者分为转移组31例和未转移组69例，所有患者均做DCE-MRI、DWI检查和血清 c-Met、MACC1检测。比较两组患者的DCE-MRI定量参数[血管外细胞外间隙容积分数(Ve)、容量转移常数(Ktrans)与速率常数(Kep)]、平均表观扩散系数(ADC)值及血清 c-Met、MACC1水平，计算并比较DCE-MRI、DWI与血清 c-Met、MACC1单独及联合诊断宫颈癌盆腔淋巴结转移的准确度、特异度、灵敏度。结果 两组患者的Ve比较差异无统计学意义(P>0.05)；转移组患者的Ktrans、Kep分别为(0.30±0.07)/min、(0.47±0.06)/min，明显高于未转移组的(0.22±0.05)/min、(0.43±0.07)/min，平均ADC值为0.82±0.15，明显低于未转移组的1.33±0.24，差异均有统计学意义(P<0.05)；转移组患者的 c-Met、MACC1水平分别为(127.53±27.48) μg/L、(9.24±3.01) ng/mL，明显高于未转移组的(81.25±18.75) μg/L、(5.21±1.37) ng/mL，差异均具有统计学意义(P<0.05)；DCE-MRI、DWI与血清 c-Met、MACC1四者联合诊断宫颈癌盆腔淋巴结转移的准确度、特异度、灵敏度均明显高于四者单独诊断，差异均具有统计学意义(P<0.05)。结论 DCE-MRI、DWI联合血清c-Met、MACC1对宫颈癌盆腔淋巴结转移的诊断价值较高。
      【关键词】 宫颈癌；盆腔淋巴结转移；动态增强扫描成像；弥散加权成像；人原癌基因编码蛋白；结肠癌转移相关基因1；诊断价值
      【中图分类号】 R737.33 【文献标识码】 A 【文章编号】 1003—6350（2023）23—3446—05

Diagnostic value of dynamic contrast enhanced magnetic resonance imaging, diffusion-weighted imaging combinedwith serum c-Met and metastasis associated gene 1 in cervical cancer with pelvic lymph node metastasis.
LI Zhen-yu 1,NIU Yong-chao 2, YAN Shao-hua 2, WAN Xiao-min 1. 1. Department of Imaging, Xinxiang Infectious Disease Hospital,Xinxiang 453000, Henan, CHINA; 2. Department of Imaging, Xinxiang Central Hospital, Xinxiang 453000, Henan, CHINA
【Abstract】 Objective To investigate the diagnostic value of dynamic contrast enhanced magnetic resonanceimaging (DCE-MRI), diffusion-weighted imaging (DWI) combined with serum human proto-oncogene coding protein(c-Met) and metastasis-associated gene 1 in colon cancer (MACC1) in cervical cancer with pelvic lymph node metasta-sis of cervical cancer. Methods The clinical data of 100 patients with cervical cancer diagnosed and treated in Xinx-iang Central Hospital from January 2021 to December 2022 were retrospectively analyzed. They were divided into meta-static group (31 cases) and non-metastatic group (69 cases) according to whether pelvic lymph node metastasis occurred.All patients underwent DCE-MRI, DWI, serum c-Met and MACC1 detection. Quantitative parameters of DCE-MRI [in-cluding extravascular extracellular space volume fraction (Ve), volume transfer constant (Ktrans), and the rate constant(Kep)], average apparent diffusion coefficient (ADC), and serum c-Met and MACC1 levels were compared between thetwo groups. The accuracy, specificity, and sensitivity of DCE-MRI, DWI, serum c-Met and MACC1 alone and in combina-tion in the diagnosis of cervical cancer with pelvic lymph node metastasis were calculated and compared. Results Therewas no significant difference in Ve between the two groups (P>0.05). The values of Ktrans and Kep in the metastatic groupwere (0.30±0.07)/min and (0.47±0.06)/min, which were significantly higher than (0.22±0.05)/min and (0.43±0.07)/minin the non-metastatic group, and the average ADC value was 0.82 ± 0.15, significantly lower than 1.33 ± 0.24 in thenon-metastatic group (P<0.05). The levels of c-Met and MACC1 in the metastatic group were (127.53±27.48) μg/L and(9.24±3.01) ng/mL, which were significantly higher than (81.25±18.75) μg/L and (5.21±1.37) ng/mL in the non-metastat-ic group (P<0.05). The accuracy, specificity, and sensitivity of DCE-MRI, DWI, serum c-Met, and MACC1 in combina-tion in the diagnosis of cervical cancer with pelvic lymph node metastasis were significantly higher than those of each in-dex alone, and the differences were statistically significant (P<0.05). Conclusion DCE-MRI, DWI combined with se-rum c-Met and MACC1 have high diagnostic value for cervical cancer with pelvic lymph node metastasis.
      【Key words】 Cervical cancer; Pelvic lymph node metastasis; Dynamic contrast enhanced magnetic resonance im-aging; Diffusion-weighted imaging; Human proto-oncogene coding protein; Metastasis-related gene 1 in colon cancer;Diagnostic value