摘要
目的 探究磁共振(Magnetic Resonance Imaging,MRI)动态增强成像与微小核糖核酸-181a(miR-181a)、微小核糖核酸-487a(miR-487a)在乳腺癌(Breast cancer,BC)诊断中的应用价值。方法 选取2022年1月至2023年1月医院确诊为BC的患者120例为BC组,同期选择在医院确诊为乳腺良性病变患者120例为良性病变组,均行MRI检查,计算转运常数(transport constant,Ktrans)、血管外细胞外容积分数(extracellular volume,Ve)、速率常数(rate constant,Kep)等参数。采用实时荧光定量PCR(Real-time fluorescence quantitative PCR,qRT-PCR)检测血清miR-181a、miR-487a的相对表达量。受试者工作特征(receiver operating characteristic,ROC)曲线分析MRI动态增强成像联合血清miR-181a、miR-487a水平对BC的诊断价值;影响BC发生的多元Logistic回归分析。结果 BC组患者血清中miR-181a的表达水平(0.85±0.12)显著低于良性病变组的(1.01±0.11),miR-487a水平(1.21±0.14)显著高于良性病变组的(1.02±0.12)(P<0.05)。miR-181a、miR-487a表达水平与BC组患者肿瘤直径、腋窝淋巴结转移、TNM分期有关(P<0.05)。BC组患者的MRI动态增强成像指标中K^(trans)、K_(ep)(0.12±0.03)min^(-1)、(1.10±0.22)min^(-1)显著高于良性病变组的(0.07±0.04)min^(-1)、(0.85±0.10)min^(-1),BC组患者的MRI动态增强成像指标中V_(e)(0.14±0.03)显著低于良性病变组的(0.17±0.02)(P<0.05)。ROC曲线显示,miR-181a、miR-487a和MRI动态增强成像参数(K^(trans)、V_(e)、K_(ep))联合诊断BC的曲线下面积(AUC)值0.988(95%CI:0.979~0.996)高于miR-181a、miR-487a、K^(trans)、V_(e)、K_(ep)单独诊断的AUC值0.830(95%CI:0.780~0.881)、0.883(95%CI:0.839~0.927)、0.838(95%CI:0.788~0.889)、0.781(95%CI:0.721~0.841)、0.847(95%CI:0.794~0.901)(Z=11.037,P<0.001;Z=7.703,P<0.001;Z=5.028,P<0.001;Z=5.341,P<0.001;Z=7.174,P<0.001)。雌二醇(OR=2.622)、睾酮(OR=3.152)、K^(trans)(OR=2.854)、K_(ep)(OR=3.118)、V_(e)(OR=0.812)、miR-181a(OR=0.795)、miR-487a(OR=4.126)水平均是BC发生的影响因素(P<0.05)。结论 BC患者血清中miR-181a水平降低,miR-487a表达水平升高,MRI动态增强成像联合miR-181a、miR-487a水平能够提高对BC的诊断价值。
Objective To explore the value of dynamic enhanced magnetic resonance imaging(MRI)and microribonucleic acid-181a(miR-18la),microribonucleic acid-487a(miR-487a)in the early diagnosis of breast cancer(BC).Methods From January 2022 to January 2023,120 patients diagnosed with breast cancer in our hospital were regarded as the BC group.During the same period,120 patients diagnosed with breast benign lesions in our hospital were collected as the benign lesion group.All patients underwent MRI examination,and parameters such as transport constant(Kirans),extracellular volume(V。),and rate constant(Kep)were calculated.Real-time fluorescence quantitative PCR(qRT-PCR)was applied to detect the relative expression levels of miR-18la and miR-487a in serum.The diagnostic value of dynamic contrast-enhanced MRI combined with serum levels of miR-18la and miR-487a in the diagnosis of BC was analyzed using the receiver operating characteristic(ROC)curve analysis.Multiple Logistic regression analysis of influencing BC occurrence.Resulsts The expression level of miR-18la in the serum of BC group patients was significantly lower at(0.85±0.12)compared to(1.01±0.11)in the benign lesion group,and the level of miR-487a was significantly higher at(1.21±0.14)than(1.02±0.12)in the benign lesion group(P<0.05).The expression levels of miR-181a and miR-487a are related to tumor diameter,axillary lymph node metastasis,and TNM staging in BC group patients(P<0.05).The Ktrans,Kep(0.12±0.03)min-1,and(1.10±0.22)min-1 in the MRI dynamic contrast-enhanced imaging indicators of BC group patients were significantly higher than those of the benign lesion group(0.07±0.04)min-1 and(0.85±0.10)min-1,respectively.The V.(0.14±0.03)in the MRI dynamic contrast-enhanced imaging indicators of BC group patients was significantly lower than that of the benign lesion group(0.17±0.02)(P<0.05).The ROC curve shows that the area under the curve(AUC)value of the combined diagnosis of BC by miR-18la,miR-487a,and MRI dynamic enhanced imaging parameters(Ktrans,V。,Kep)is 0.988(95%CI:0.979~0.996),which is higher than the AUC values of miR-18la,miR-487a,Ktrans,Ve,Kep diagnosed separately,which are 0.830(95%CI:0.780~0.881),0.883(95%CI:0.839~0.927),0.838(95%CI:0.788~0.889),0.781(95%CI:0.721~0.841),0.847(95%CI:0.794~0.901)(Z=11.037,P<0.001;Z=7.703,P<0.001;Z=5.028,P<0.001;Z=5.341,P<0.001;Z=7.174,P<0.001).Estradiol(OR=2.622),testosterone(OR=3.152),Ktrans(OR=2.854),Kep(OR=3.118),V。(OR=0.812),miR-181a(OR=0.795)and miR-487a(OR=4.126)levels were all influencing factors for the occurrence of BC patients(P<0.05).Conclusion The level of miR-18la in the serum of BC patients decreases,while the expression level of miR-487a increases.Dynamic contrast-enhanced MRI combined with miR-18la and miR-487a levels can improve the diagnostic valueof BC.
作者
刘平安
谭凡
陈文
LIU Pingan;TAN Fan;CHEN Wen(Medical Imaging Center of Taihe Hospital,Shiyan,Hubei 442000,China;Department of Nuclear Medicine,Taihe Hospital,Shiyan,Hubei 442000,China)
出处
《中国实验诊断学》
2025年第5期544-550,共7页
Chinese Journal of Laboratory Diagnosis
基金
2019年度十堰市太和医院院级基金项目(2019JJXM047)。
