摘要
目的:探讨子宫肌瘤患者动态对比增强磁共振成像(DCE-MRI)参数、血清癌胚抗原(CEA)水平变化,并分析其对术后复发的预测价值。方法:回顾性选取2021年10月至2023年10月于义马煤业集团有限公司总医院诊治的124例子宫肌瘤患者为研究对象,依据子宫肌瘤剔除术后6个月是否复发分为复发组23例、未复发组101例。比较两组临床资料及DCE-MRI参数[血管外细胞外间隙容积分数(Ve)、血管间隙容积分数(Vp)、速率常数(Kep)]、血清CEA水平。分析术后复发的影响因素。分析DCE-MRI参数、血清CEA与术后复发的关系。评价DCE-MRI参数、血清CEA对术后复发的预测价值。结果:复发组术后7 d Ve、Vp、Kep及血清CEA水平高于未复发组(P<0.05);肌瘤数目、肌瘤最大直径、Ve、Vp、Kep、血清CEA水平为术后复发的独立危险因素(P<0.05);调整肌瘤数目、肌瘤最大直径、混杂因素后,Ve、Vp、Kep、CEA高表达者术后复发风险分别为低表达者的2.691倍、2.538倍、2.263倍、2.016倍(P<0.05);术后7 d Ve、Vp、Kep、血清CEA联合预测术后复发的AUC值大于单项指标预测(P<0.05)。结论:子宫肌瘤术后复发者Ve、Vp、Kep及血清CEA水平升高,且为术后复发的危险因素,联合检测其水平对术后复发具有一定预测价值。
Objective:To investigate the dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)parameters and serum carcinoembryonic antigen(CEA)level changes in patients with uterine fibroids,and to analyze their predictive value for postoperative recurrence.Methods:A retrospective study was conducted on 124 patients with uterine fibroids who were diagnosed and treated in the General Hospital of Yima Coal Industry Group Co.,Ltd.from October 2021 to October 2023.The patients were divided into a recurrence group(n=23)and a non-recurrence group(n=101)based on whether they experienced recurrence 6 months after myomectomy.The clinical data,DCE-MRI parameters[extravascular extracellular space volume fraction(Ve),vascular space volume fraction(Vp),rate constant(Kep)]and serum CEA levels were compared between the two groups.The influencing factors of postoperative recurrence were analyzed.The relationships between DCE-MRI parameters,serum CEA and postoperative recurrence were analyzed.The predictive value of DCE-MRI parameters and serum CEA for postoperative recurrence was evaluated.Results:The Ve,Vp,Kep and serum CEA levels in the recurrence group were higher than those in the non-recurrence group 7 days after surgery(P<0.05).The number of fibroids,the maximum diameter of fibroids,Ve,Vp,Kep and serum CEA levels were independent risk factors for postoperative recurrence(P<0.05).After adjusting for the number of fibroids,the maximum diameter of fibroids and confounding factors,the postoperative recurrence risks for patients with high Ve,Vp,Kep and CEA expressions were 2.691,2.538,2.263 and 2.016 times higher,respectively,than those with low expressions(P<0.05).The area under the curve(AUC)for the combined prediction of postoperative recurrence by Ve,Vp,Kep,and serum CEA 7 days after surgery was greater than that for individual indicator(P<0.05).Conclusion:The Ve,Vp,Kep and serum CEA levels were elevated in patients with postoperative recurrence of uterine fibroids and were risk factors for postoperative recurrence.The combined detection of these levels has certain predictive value for postoperative recurrence.
作者
芦琳
李秋实
王百爽
徐婧媛
LU Lin;LI Qiushi;WANG Baishuang;XU Jingyuan(Magnetic Resonance Room,General Hospital of Yima Coal Industry Group Co.,Ltd.,Sanmenxia 472300,China;Department of Medical Imaging,The First Affiliated Hospital of Henan University,Kaifeng 475200,China;Department of Medical Imaging,Anyang Regional Hospital of Puyang,Anyang 455000,China;MRI Diagnostic Center,Central Hospital of Sanmenxia City,Sanmenxia 472000,China)
出处
《黑龙江医药科学》
2025年第6期96-99,共4页
Heilongjiang Medicine and Pharmacy
基金
河南省医学科技攻关联合共建项目,编号:LHGJ20211006。
关键词
子宫肌瘤
动态对比增强磁共振成像
癌胚抗原
复发
预测
uterine fibroids
dynamic contrast-enhanced magnetic resonance imaging
carcinoembryonic antigen
recurrence
prediction
