Application value of multi-slice spiral CT combined with carbohydrate antigen 125 and alpha fetoprotein in preoperative lymph node staging of rectal cancer
10.3760/cma.j.cn115355-20230915-00109
- VernacularTitle:多层螺旋CT联合糖类抗原125、甲胎蛋白在直肠癌术前淋巴结分期中的应用价值
- Author:
Kechun LUO
1
;
Junjun BAO
Author Information
1. 海安市中医院放射科，南通 226600
- Keywords:
Rectal neoplasms;
Multi-slice spiral CT;
Carbohydrate antigen 125;
Alpha fetoprotein;
Lymph node metastasis;
Diagnosis
- From:
Cancer Research and Clinic
2024;36(5):351-355
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application value of multi-slice spiral CT combined with carbohydrate antigen 125 (CA125) and alpha fetoprotein (AFP) in preoperative lymph node staging of rectal cancer.Methods:A retrospective case series study was performed. The clinical data of 90 patients with rectal cancer confirmed by pathology after operation at Haian Traditional Chinese Medicine Hospital from August 2020 to August 2022 were retrospectively analyzed. Multi-slice spiral CT was used to judge the diagnostic consistency between preoperative N stage and pathological N stage. The levels of serum CA125 and AFP in patients with different pathological N stages (N 0 stage, N 1 stage, N 2 stage) were compared. Taking postoperative pathological results as the gold standard, logistic regression was used to analyze the correlation between multi-slice spiral CT, CA125, and AFP with lymph node metastasis in rectal cancer. The receiver operating characteristic (ROC) curve was constructed to evaluate the diagnostic efficacy of multi-slice spiral CT combined with CA125 and AFP for lymph node metastasis. Results:The pathological staging results showed that there were 44 cases in N 0 stage, 33 cases in N 1 stage, and 13 cases in N 2 stage. Multi-slice spiral CT staging results showed that there were 49 cases in N 0 stage, 26 cases in N 1 stage, and 15 cases in N 2 stage. The consistency between pathological staging and multi-slice spiral CT staging occurred in 34 cases in N 0 stage, 15 cases in N 1 stage and 5 cases in N 2 stage. The serum CA125 level in the pathological N 0, N 1, and N 2 stages groups was (15.8±1.4) U/ml, (38.9±2.4) U/ml, and (85.4±3.3) U/ml, respectively, and the difference was statistically significant ( F = 5 519.47, P< 0.05). The AFP level was (37.8±2.5) ng/ml, (79.3±4.6) ng/ml, and (168.3±5.9) ng/ml, respectively, and the difference was statistically significant ( F = 5 583.80, P < 0.05). Logistic regression analysis showed that N staging ( OR = 6.231,95% CI: 2.164-17.939, P = 0.001) and AFP ( OR = 1.020, 95% CI: 1.002-1.039, P = 0.032) were independent factors influencing the metastasis of lymph node in rectal cancer patients. ROC curve analysis showed that the area under the curve of AFP, CA125, multi-slice spiral CT, and the combination of the 3 in the diagnosis of lymph node metastasis was 0.850, 0.731, 0.745, and 0.912, respectively. Conclusions:Multi-slice spiral CT combined with serum CA125 and AFP has a high value in the diagnosis of preoperative lymph node staging of rectal cancer.
