Hepatobiliary Surgery, Qingdao Jiaozhou Central Hospital, Qingdao 266300, Shandong Province, China.
Radiology Department, Jinan Fourth People's Hospital, Jinan 250031, Shandong Province, China.
J Healthc Eng. 2022 Mar 29;2022:7984591. doi: 10.1155/2022/7984591. eCollection 2022.
To explore the diagnostic value of dynamic enhanced magnetic resonance imaging (MRI) combined with serum CA15-3, CYFRA21-1, and TFF1 for breast cancer.
By means of a retrospective study, 60 breast cancer patients treated in our hospital from January 2018 to December 2020 were selected as the breast cancer group, 60 patients with benign breast lesions were selected as the benign group, and 60 healthy individuals who received physical examination in our hospital in the same period were selected as the control group. All study subjects received dynamic enhanced MRI scan and serological tests, their serum CA15-3 and CYFRA21-1 levels were measured with the electrochemiluminescence instrument and original auxiliary reagent, and the TFF1 level was measured with enzyme-linked immunosorbent assay (ELISA). The MRI performance variation in breast lesion patients was analyzed, the serum CA15-3, CYFRA21-1, and TFF1 levels of study subjects were compared among the three groups, and the efficacy of single diagnosis by dynamic enhanced MRI, CA15-3, CYFRA21-1, or TFF1 as well as combined diagnosis was explored by ROC curves.
Dynamic enhanced MRI showed that malignant lesion had obscure boundary, irregular margin, and heterogeneity after enhancement, and the time-signal intensity curve presented fast-in fast-out; the benign lesion had a clear boundary and smooth margin, 25 cases showed homogeneity after enhancement, and the time-signal intensity curve presented slow-in slow-out; the CA15-3, CYFRA21-1, and TFF1 levels were significantly different among the breast cancer group, benign group, and control group (33.81 ± 12.46 vs 19.02 ± 6.47 vs 9.55 ± 2.64, 4.08 ± 1.41 vs 1.96 ± 1.19 vs 0.99 ± 0.21, 1.39 ± 0.54 vs 1.04 ± 0.26 vs 0.89 ± 0.12, < 0.05); 57 breast cancer patients were diagnosed by a combined examination, with a sensitivity of 95.0%, specificity of 83.3%, positive predictive value of 74.0%, negative predictive value of 97.1%, accuracy rate of 87.2%, and AUC (95%CI) = 0.892 (0.840-0.943), indicating a significantly higher diagnostic value of the combined examination than the single examination by CA15-3, CYFRA21-1, TFF1, or MRI.
Combining dynamic enhanced MRI with serum CA15-3, CYFRA21-1, and TFF1 has good efficacy in diagnosing breast cancer, which can be applied in clinical diagnosis of breast cancer.
探讨动态增强磁共振成像（MRI）联合血清 CA15-3、CYFRA21-1、TFF1 对乳腺癌的诊断价值。
采用回顾性研究，选取 2018 年 1 月至 2020 年 12 月我院收治的 60 例乳腺癌患者为乳腺癌组，同期选取 60 例良性乳腺病变患者为良性组，选取同期我院体检的 60 例健康者为对照组。所有研究对象均接受动态增强 MRI 扫描和血清学检查，采用电化学发光仪及原装辅助试剂检测血清 CA15-3 和 CYFRA21-1 水平，采用酶联免疫吸附试验（ELISA）检测 TFF1 水平。分析乳腺病变患者的 MRI 表现变化，比较三组研究对象的血清 CA15-3、CYFRA21-1、TFF1 水平，并通过 ROC 曲线探讨动态增强 MRI、CA15-3、CYFRA21-1、TFF1 单项诊断及联合诊断的效果。
动态增强 MRI 显示恶性病灶边界模糊，边缘不规则，增强后呈异质性，时间-信号强度曲线呈快进快出；良性病灶边界清晰，边缘光滑，增强后 25 例呈均匀性，时间-信号强度曲线呈慢进慢出；乳腺癌组、良性组和对照组的 CA15-3、CYFRA21-1、TFF1 水平差异均有统计学意义（33.81±12.46 比 19.02±6.47、4.08±1.41 比 1.96±1.19、1.39±0.54 比 1.04±0.26，均 P<0.05）；57 例乳腺癌患者联合检查诊断，灵敏度为 95.0%，特异度为 83.3%，阳性预测值为 74.0%，阴性预测值为 97.1%，准确率为 87.2%，曲线下面积（95%CI）为 0.892（0.840~0.943），提示联合检查的诊断价值明显高于 CA15-3、CYFRA21-1、TFF1 或 MRI 单项检查。
动态增强 MRI 联合血清 CA15-3、CYFRA21-1、TFF1 对乳腺癌的诊断效果较好，可应用于乳腺癌的临床诊断。
