Clinical study of DCE-MRI parameters combined with Serum CA19-9 and CA724 levels in evaluating the differentiation degree of rectal cancer patients

ZHANG Jing; ZHAO Liang; WU Yongjie

doi:10.19732/j.cnki.2096-6210.2022.03.014

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Clinical study of DCE-MRI parameters combined with Serum CA19-9 and CA724 levels in evaluating the differentiation degree of rectal cancer patients

更新时间：2025-12-15

- Clinical study of DCE-MRI parameters combined with Serum CA19-9 and CA724 levels in evaluating the differentiation degree of rectal cancer patients
- Vol. 31, Issue 3, Pages: 301-308(2022)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2022.03.014
  CLC：
- Published Online：28 June 2022，
  
  Published：28 June 2022
- 稿件说明：
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张静,赵亮,武永杰. DCE-MRI参数联合血清CA19-9、CA724水平评价直肠癌患者分化程度的临床研究[J]. 肿瘤影像学, 2022, 31(3): 301-308 https://doi.

org/10.19732/j.cnki.2096-6210.2022.03.014
张静,赵亮,武永杰. DCE-MRI参数联合血清CA19-9、CA724水平评价直肠癌患者分化程度的临床研究[J]. 肿瘤影像学, 2022, 31(3): 301-308 https://doi. DOI： 10.19732/j.cnki.2096-6210.2022.03.014.

org/10.19732/j.cnki.2096-6210.2022.03.014 DOI：

摘要

目的：

探讨动态增强磁共振成像（dynamic contrast-enhanced magnetic resonance imaging，DCE-MRI）参数联合血清糖类抗原（carbohydrate antigen，CA）19-9、CA724水平评价直肠癌患者分化程度的价值。

方法：

选取2018年5月2020年11月长治市人民医院收治的经病理学检查确诊的129例直肠癌患者为研究对象，均于治疗前行DCE-MRI检查及血清CA19-9、CA724水平检测。比较不同肿瘤分化程度（中/高分化、未/低分化）患者DCE-MRI参数及血清CA19-9、CA724水平，另采用受试者工作特征（receiver operating characteristic，ROC）曲线分析DCE-MRI参数及血清CA19-9、CA724水平对直肠癌患者分化程度的评估作用。

结果：

高/中分化患者容量转运常数（volume transfer constant，K

trans

）、血管外细胞外间隙容积分数（extracellular volume fraction，V

）、增强的曲线下面积（intensive area under the cure，iAUC）及血清CA19-9、CA724水平均低于未/低分化者（

＜0.05），平均表观弥散系数（mean apparent diffusion coefficient，ADC

mean

）值高于未/低分化者（

＜0.05）；DCE-MRI各参数联合对直肠癌患者分化程度评估的灵敏度、特异度、AUC分别为81.25%、82.47%、0.792，灵敏度和AUC均高于单独预测（

＜0.01），特异度与单独预测对比差异均无统计学意义（

＞0.05）；DCE-MRI参数联合血清CA19-9、CA724水平对直肠癌患者分化程度评估的灵敏度、特异度、AUC分别为96.88%、85.57%、0.889，灵敏度和AUC均高于单独预测（

＜0.01），特异度与单独预测对比差异均无统计学意义（

＞0.05）。

结论：

DCE-MRI参数中K

trans

、iAUC、V

及血清CA19-9、CA724水平均随着直肠癌分化程度降低而升

高，ADC

mean

值随直肠癌分化程度降低而降低，均可作为临床评估直肠癌分化程度的指标之一，且上述指标联合评估时的作用更优，临床价值更为明显，对临床病情判断及治疗选择具有重要指导意义。

Abstract

Objective:

To explore the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters combined with serum carbohydrate antigen (CA) 19-9 and CA724 levels in evaluating the differentiation degree of rectal cancer.

Methods:

A total of 129 patients with rectal cancer diagnosed by pathology in Changzhi peoples Hospital from May 2018 to November 2020 were selected as the research objects. DCE-MRI examination and serum CA19-9

CA724 levels were detected before treatment. DCE-MRI parameters and serum CA19-9 and CA724 levels in patients with different tumor differentiation degrees (high differentiation

medium/low differentiation) were compared. Receiver operating characteristic (ROC) curve was used to analyze the value of DCE-MRI parameters and serum CA19-9 and CA724 levels in evaluating the differentiation degree of rectal cancer patients.

Results:

Volume transport constant (K

trans

)

intensive area under the cure (iAUC)

volume fraction of extracellular space (V

) and serum CA19-9

CA724 levels of high/medium differentiation differentiated patients were lower than those of undifferentiated/poorly differentiated patients (

＜0.05). Mean apparent diffusion coefficient (ADC

mean

) value of high/medium patients was higherthan that of undifferentiated/poorly differentiated patients (

＜0.05). The sensitivity

specificity and AUC of DCE-MRI were 81.25%

82.47% and 0.792 respectively. The sensitivity and AUC were higher than those of single prediction (

＜0.05). There was no significant difference between the specificity and single prediction (

＞0.05). The sensitivity

specificity and AUC of DCE-MRI parameters combined with serum CA19-9 and CA724 levels in evaluating the differentiation degree of rectal

cancer patients were 96.88%

85.57% and 0.889

respectively. The sensitivity and AUC of combined prediction were higher than those of single prediction (

＜0.01)

and there was no significant difference between combined prediction and single prediction (

＞0.05).

Conclusion:

In DCE-MRI parameters

trans

iAUC

and serum CA19-9

CA724 levels increase with the decrease of rectal cancer differentiation degree

ADC

mean

value decreases with the decrease of rectal cancer differentiation degree

which can be used as one of the indicators for clinical evaluation of rectal cancer differentiation degree

and the above indicators play a better role in joint evaluation. The value is more obvious

which has important guiding significance for clinical condition judgment and treatment choice.

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