摘要
目的探讨弥散加权成像(DWI)联合免疫球蛋白G4(IgG4)对自身免疫性胰腺炎(AIP)及胰腺导管腺癌(PDAC)的诊断价值。方法回顾性收集金华市人民医院2018年2月至2023年2月收治的65例AIP患者和40例PDAC患者的临床资料,比较两组患者表观弥散系数(ADC)值、IgG4、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)水平,采用ROC曲线分析ADC、IgG4单独及联合诊断PDAC的效能。结果AIP组的ADC值、CEA、CA19-9水平均低于PDAC组,IgG4水平高于PDAC组,差异均有统计学意义(均P<0.05)。ADC值、CEA、CA19-9、IgG4联合诊断PDAC的AUC为0.958,灵敏度和特异度分别为0.950、0.892。结论DWI联合IgG4检测在AIP与PDAC鉴别诊断中有一定价值,同时联合ADC值、CEA、CA19-9、IgG4诊断PDAC的AUC、灵敏度和特异度均高于单一指标,表明其具有更高的诊断价值和准确度。
Objective To investigate the diagnostic value of diffusion-weighted imaging(DWI)combined with immunoglobulin G4(IgG4)for autoimmune pancreatitis(AIP)and pancreatic ductal adenocarcinoma(PDAC).Methods Clinical data from 65 patients with AIP and 40 patients with PDAC treated in Jinhua People's Hospital between February 2018 and February 2023 were retrospectively collected.The apparent diffusion coefficient(ADC)values,IgG4,carcinoembryonic antigen(CEA),and carbohydrate antigen 19-9(CA19-9)levels were compared between the two groups.ROC curve analysis was performed to evaluate the predictive performance of ADC,IgG4,and their combination for PDAC occurrence.Results The levels of ADC value,CEA,and CA19-9 in the AIP group were all lower than those in the PDAC group,while the IgG4 level was higher than that in the PDAC group,with all differences being statistically significant(all P<0.05).The AUC for the combination of ADC value,CEA,CA19-9,and IgG4 in predicting PDAC was 0.958,with a sensitivity of 0.950 and a specificity of 0.892.Conclusion The combination of DWI and IgG4 detection has certain value in the differential diagnosis of AIP and PDAC.Meanwhile,the combination of ADC value,CEA,CA19-9,IgG4 has higher AUC,sensitivity,and specificity in distinguishing PDAC than a single indicator,indicating that it has higher predictive value and accuracy.
作者
徐婷婷
应结草
何筱妍
吕小娇
XU Tingting;YING Jiecao;HE Xiaoyan;LYU Xiaojiao(Department of Radiology,Jinhua People's Hospital,Jinhua 321000,China;不详)
出处
《浙江医学》
2026年第5期532-536,共5页
Zhejiang Medical Journal
基金
金华市科技计划项目(2023-4-112)。
关键词
弥散加权成像
免疫球蛋白G4
自身免疫性胰腺炎
胰腺导管腺癌
Diffusion-weighted imaging
Immunoglobulin G4
Autoimmune pancreatitis
Pancreatic ductal adenocarcinoma
