实用肿瘤学杂志 ›› 2025, Vol. 39 ›› Issue (1): 56-60.doi: 10.11904/j.issn.1002-3070.2025.01.008

• 临床应用 • 上一篇    下一篇

DCE-MRI定量参数联合NCAPH检测诊断早期乳腺癌的价值分析

石长勇1, 周紫珍1, 周广林1, 熊益敏2   

  1. 1.深圳市龙岗区妇幼保健院(汕头大学医学院龙岗妇幼临床学院)乳腺外科(深圳 518172);
    2.深圳市龙岗区妇幼保健院(汕头大学医学院龙岗妇幼临床学院)放射科
  • 收稿日期:2023-11-14 修回日期:2024-12-19 出版日期:2025-02-28 发布日期:2025-03-19
  • 通讯作者: 熊益敏,E-mail:13714606752@qq.com
  • 作者简介:石长勇,男,(1978-),硕士,副主任医师,从事乳腺癌的临床与基础方向的研究。
  • 基金资助:
    深圳市龙岗区经济与科技发展专项资金医疗卫生科技计划项目(编号:LGKCYLWS2020110)

The values of DCE-MRI quantitative parameters combined with NCAPH in the diagnosis of early breast cancer

SHI Changyong1, ZHOU Zizhen1, ZHOU Guanglin1, XIONG Yimin2   

  1. 1. Department of Breast Surgery,Longgang District Maternity & Child Healthcare Hospital of Shenzhen City(Longgang Maternity and Child Institute of Shantou University Medical College),Shenzhen 518172,China;
    2. Department of Radiology,Longgang District Maternity & Child Healthcare Hospital of Shenzhen City(Longgang Maternity and Child Institute of Shantou University Medical College)
  • Received:2023-11-14 Revised:2024-12-19 Online:2025-02-28 Published:2025-03-19

摘要: 目的 分析动态增强磁共振成像(dynamic contrast enhanced-magnetic resonance imaging,DCE-MRI)定量参数联合染色体凝聚素I复合物H亚单位(non-SMC condensinⅠcomplex subunit H,NCAPH)检测,对早期乳腺癌诊断的价值。方法 选取2020年3月—2022年3月于深圳市龙岗区妇幼保健院乳腺外科就诊的96例乳腺结节患者为研究对象,均行DCE-MRI检查,记录转运常数(Ktrans)及速率常数(Kep);实时荧光定量聚合酶链反应(qRT-PCR)检测血清NCAPH mRNA表达水平;以病理检查结果为金标准,病理诊断为乳腺结节患者为良性组,乳腺癌患者为乳腺癌组,比较良性组与乳腺癌组之间DCE-MRI定量参数Ktrans、Kep及血清NCAPH mRNA的差异,分析Ktrans、Kep、血清NCAPH mRNA及三者联合诊断早期乳腺癌的准确率、敏感度、特异度差异,采用Kappa检验法比较其与病理结果的一致性。结果 经病理检查结果证实,96例乳腺结节患者中良性结节31例、乳腺癌患者65例;乳腺癌组Ktrans、Kep及NCAPH mRNA均显著高于良性组(P<0.05);Ktrans、Kep及NCAPH联合应用诊断早期乳腺癌的AUC为0.944,明显高于Ktrans、Kep单独诊断,其敏感度、特异度分别为96.92%、77.42%;Ktrans、Kep联合NCAPH检出假阳性7例,假阴性2例,Kappa值为0.776(P<0.05),与病理结果一致性较好;DCE-MRI定量参数联合NCAPH诊断早期乳腺癌的敏感度明显高于DCE-MRI定量参数、血清NCAPH单独诊断(P<0.05)。结论 乳腺癌患者DCE-MRI定量参数Ktrans、Kep及血清NCAPH mRNA表达水平均较高,Ktrans、Kep联合血清NCAPH检测诊断早期乳腺癌具有一定临床应用价值。

关键词: 动态增强磁共振成像, 转运常数, 速率常数, 染色体凝聚素I复合物H亚单位, 乳腺癌

Abstract: Objective The aim of this study was to analyze the value of quantitative parameters of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)combined with the detection of non-SMC condensing Ⅰ complex subunit H(NCAPH)in the diagnosis of early breast cancer. Methods Ninety-six patients with breast nodules who were treated in the department of Breast Surgery at Longgang District Maternity & Child Healthcare Hospital in Shenzhen from March 2020 to March 2022 were selected as the study objects.DCE-MRI examination was performed on all patients,and transport constant(Ktrans)and rate constant(Kep)were recorded.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was used to detect the expression of serum NCAPH mRNA.Based on the results of pathological examination as the gold standard,the patients with breast nodules diagnosed pathologically as the benign group and the patients with breast cancer as the breast cancer group,the differences of DCE-MRI quantitative parameters Ktrans,Kep and serum NCAPH mRNA between the benign group and the breast cancer group were compared.The accuracy,sensitivity and specificity of serum NCAPH mRNA and their combination in the diagnosis of early breast cancer were different.Kappa test was used to compare the consistency with the pathological results. Results The results of pathological examination confirmed that there were 31 benign nodules and 65 breast cancer in 96 patients with breast nodules.Ktrans,Kep and NCAPH mRNA in the breast cancer group were significantly higher than those in the benign group(P<0.05);The AUC of Ktrans,Kep and NCAPH in the diagnosis of early breast cancer was 0.944,which was significantly higher than that of Ktrans and Kep alone,with the sensitivity and specificity of 96.92% and 77.42%,respectively;Ktrans and Kep combined with NCAPH detected 7 false positives and 2 false negatives,with a Kappa value of 0.776(P<0.05),which was consistent with the pathological results;The sensitivity of DCE-MRI quantitative parameters combined with NCAPH in the diagnosis of early breast cancer was significantly higher than that of DCE-MRI quantitative parameters and serum NCAPH alone(P<0.05). Conclusion The expression of Ktrans,Kep and serum NCAPH mRNA in breast cancer patients with DCE-MRI quantitative parameters is high.Ktrans,Kep combined with serum NCAPH detection has certain clinical values in the diagnosis of early breast cancer.

Key words: Dynamic contrast enhanced-magnetic resonance imaging, Transport constant, Rate constant, Non-SMC condensing Ⅰ complex subunit H, Breast cancer

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