增强CT联合血清DSG2、HOXB7对乳腺癌腋窝淋巴结转移的诊断价值-现代医学

增强CT联合血清DSG2、HOXB7对乳腺癌腋窝淋巴结转移的诊断价值

单位：1. 山西医科大学第二医院放射科, 山西太原 030001;
2. 山西医科大学第二医院 CT室, 山西太原 030001

分类号：R737.9

出版年·卷·期（页码）：2025·53·第九期（1473-1478）

摘要：

目的： 探究增强CT联合血清桥粒黏蛋白2(DSG2)、同源盒基因B7(HOXB7)对乳腺癌(BC)患者腋窝淋巴结转移(ALNM)的诊断价值。方法： 选取2022年2月至2024年4月在本院治疗的BC患者112例，以ALNM术后病理结果为金标准，分为无转移组(54例)和转移组(58例)。采用酶联免疫吸附法(ELISA)检测血清DSG2、HOXB7水平；受试者工作特征(ROC)曲线分析血清DSG2、HOXB7水平对BC患者发生ALNM的诊断价值；四格表法分析增强CT联合血清DSG2、HOXB7水平对BC患者发生ALNM诊断结果。结果： 与无转移组比较，转移组血清DSG2水平显著降低，血清HOXB7水平显著升高(P＜0.05)；血清DSG2、HOXB7水平诊断BC患者ALNM的ROC 曲线下面积(AUC)分别为0.806、0.830，截断值分别为2.54ng·mL^-1、1.10 ng·mL^-1。增强CT联合血清DSG2、HOXB7水平诊断BC患者发生ALNM的预测值为97.67%，BC患者未发生ALNM的预测值为76.81%，与病理检查结果一致性较高(Kappa=0.716，P<0.001)；其灵敏度、特异度、准确率分别为72.41%、98.15%、84.82%。三者联合诊断BC患者发生ALNM的灵敏度显著低于血清HOXB7水平单独诊断(P<0.05)，但三者联合特异度显著高于血清DSG2、HOXB7水平和增强CT单独诊断(P<0.05)，且三者联合准确率显著高于增强CT单独诊断(P<0.05)。结论： BC发生ALNM患者血清中DSG2表达下调、HOXB7表达上调，二者对BC患者发生ALNM有一定的诊断价值，增强CT联合血清DSG2、HOXB7水平对BC患者发生ALNM的诊断效能更高。

Objective: To explore the diagnostic value of enhanced CT combined with serum desmoglein-2(DSG2) and homeobox gene B7(HOXB7) for axillary lymph node metastasis(ALNM) in patients with breast cancer(BC). Methods: A total of 112 BC patients who were treated in our hospital from February 2022 to April 2024 were selected. Based on the postoperative pathological results as the gold standard for ALNM, they were divided into the non-metastasis group(54 cases) and the metastasis group(58 cases). The levels of serum DSG2 and HOXB7 were detected by enzyme-linked immunosorbent assay(ELISA); receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of serum DSG2 and HOXB7 levels for ALNM in BC patients; four grid table method was applied to analyze the diagnostic results of enhanced CT combined with serum DSG2 and HOXB7 levels for ALNM in BC patients. Results: Compared with the non-metastatic group, the serum DSG2 level was prominently lower and the serum HOXB7 level was prominently higher in the metastatic group(P<0.05). The area under the ROC curve(AUC) of serum DSG2 and HOXB7 levels in diagnosing ALNM in BC patients was 0.806 and 0.830, respectively, with cutoff values of 2.54 ng·mL^-1 and 1.10 ng·mL^-1, respectively. The predictive value of enhanced CT combined with serum DSG2 and HOXB7 levels in diagnosing ALNM in BC patients was 97.67%, and the predictive value in diagnosing BC patients without ALNM was 76.81%, which was consistent with pathological examination results(Kappa=0.716, P<0.001). The sensitivity, specificity, and accuracy were 72.41%, 98.15% and 84.82%, respectively. The sensitivity of the combination of the three in diagnosing ALNM in BC patients was prominently lower than that of serum HOXB7 levels alone(P<0.05), however, the specificity of the combination of the three was prominently higher than that of serum DSG2, HOXB7 and enhanced CT diagnosis alone(P<0.05). The combined accuracy of the three methods was prominently higher than that of enhanced CT alone(P<0.05). Conclusion: DSG2 expression is downregulated and HOXB7 expression is upregulated in serum for ALNM in BC patients. Both of them have certain diagnostic value for ALNM in BC patients, and the diagnostic efficacy of enhanced CT combined with serum DSG2 and HOXB7 levels for ALNM in BC patients is higher.

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