血清DCLK1、LTBP2联合经阴道实时剪切波弹性成像对宫颈癌的早期诊断价值

王君; 徐宁; 关三丽; 乔敏霞; 王利娜; 张慧

doi:10.11659/jjssx.10E023108

您当前的位置：

首页 >

文章列表页 >

血清DCLK1、LTBP2联合经阴道实时剪切波弹性成像对宫颈癌的早期诊断价值

临床研究 | 更新时间：2024-11-18

- 血清DCLK1、LTBP2联合经阴道实时剪切波弹性成像对宫颈癌的早期诊断价值
- Early diagnostic value of serum DCLK1, LTBP2 combined with transvaginal real-time shear wave elastography for cervical cancer
- 局解手术学杂志 2024年33卷第11期页码：1009-1013
- 作者机构：
  
  西安市人民医院/西安市第四医院超声医学中心，陕西西安 710004
- 作者简介：
  
  张慧，E-mail：lianzum3294@163.com
- 基金信息：
  
  西安市科技计划项目［20YXYJ0005（1）］
- DOI：10.11659/jjssx.10E023108
  中图分类号： R445.1;R737.33
- 纸质出版日期：2024-11-25，
  
  收稿日期：2023-10-25，
- 稿件说明：
移动端阅览
王君,徐宁,关三丽等.血清DCLK1、LTBP2联合经阴道实时剪切波弹性成像对宫颈癌的早期诊断价值[J].局解手术学杂志,2024,33(11):1009-1013.

WANG Jun,XU Ning,GUAN San-li,et al.Early diagnostic value of serum DCLK1, LTBP2 combined with transvaginal real-time shear wave elastography for cervical cancer[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(11):1009-1013.
王君,徐宁,关三丽等.血清DCLK1、LTBP2联合经阴道实时剪切波弹性成像对宫颈癌的早期诊断价值[J].局解手术学杂志,2024,33(11):1009-1013. DOI： 10.11659/jjssx.10E023108.

WANG Jun,XU Ning,GUAN San-li,et al.Early diagnostic value of serum DCLK1, LTBP2 combined with transvaginal real-time shear wave elastography for cervical cancer[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(11):1009-1013. DOI： 10.11659/jjssx.10E023108.

摘要

目的

探讨血清双皮质素样激酶1（DCLK1）、潜在转化生长因子结合蛋白2（LTBP2）联合经阴道实时剪切波弹性成像（SWE）对宫颈癌的早期诊断价值。

方法

选取2021年8月至2022年12月于本院就诊的宫颈病变患者155例为研究对象，经手术病理确诊宫颈癌患者75例（宫颈癌组）和宫颈上皮内瘤变（CIN）患者80例（CIN组），另取同期于本院体检的无宫颈相关疾病志愿者80例作为对照组。各组受试者均进行血清DCLK1、LTBP2水平检测及经阴道SWE检查。受试者工作特征（

ROC

）曲线分析血清DCLK1、LTBP2对宫颈癌的诊断价值；采用四格表法分析血清DCLK1、LTBP2联合经阴道SWE对宫颈癌的诊断价值。

结果

宫颈癌组患者血清DCLK1、LTBP2水平显著高于CIN组及对照组（

0.05）。与术前相比，宫颈癌患者术后1、3、6个月的血清DCLK1、LTBP2水平逐渐下降，各时间点两两比较差异均有统计学意义（

0.05）。血清DCLK1、LTBP2诊断宫颈癌的曲线下面积分别为0.868、0.754，敏感度为86.67%、78.67%，特异度为81.25%、60.00%，最佳截断值为1.49 ng/mL、19.02 μg/mL。宫颈癌组患者病灶组织的最大弹性模量、平均弹性模量均显著高于CIN组（

0.05）。血清DCLK1、血清LTBP2、经阴道SWE诊断宫颈癌的阳性率分别为86.67%、78.67%、82.67%，与金标准均具有一致性（

Kappa

=0.624、0.501、0.673，

0.001），三项联合诊断宫颈癌的阳性率为97.33%，与金标准的一致性较高（

Kappa

=0.846，

=0.001）；三项联合诊断的敏感度、准确度均显著高于血清DCLK1、血清LTBP2、经阴道SWE单一指标诊断，三项联合诊断的特异度显著高于血清DCLK1、LTBP2单一指标诊断，三项联合的误诊率均显著低于血清DCLK1、LTBP2单一指标诊断，

差异均有统计学意义（

0.05）。

结论

血清DCLK1、LTBP2联合经阴道SWE在宫颈癌诊断中应用价值较高，可提升诊断的敏感度、准确度，降低误诊率。

Abstract

Objective

To investigate the early diagnostic value of serum double cortin-like kinase 1 （DCLK1），latent transforming growth factor binding protein 2 （LTBP2） combined with transvaginal real-time shear wave elastography （SWE） for cervical cancer.

Methods

A total of 155 patients with cervical lesions treated in our hospital from August 2021 to December 2022 were selected as the research objects.Seventy-five patients with cervical cancer （the cervical cancer group） and 80 patients with cervical intraepithelial neoplasia （the CIN group） were diagnosed by surgical pathology， another 80 volunteers without cervical related diseases who participated in physical examinations at our hospital during the same period were selected as the control group.All subjects of each groups underwent serum DCLK1 and LTBP2 levels detection and transvaginal SWE examination.

Receiver operating characteristic

（

ROC

） curve was used to analyze the diagnostic value of serum DCLK1 and LTBP2 for cervical cancer；the diagnostic value of serum DCLK1 and LTBP2 combined with transvaginal SWE for cervical cancer was analyzed by fourfold table analysis.

Results

The serum levels of DCLK1 and LTBP2 of patients in the cervical cancer group were obviously higher than those in the CIN group and the control group （

0.05）.Compared with before surgery， the serum levels of DCLK1 and LTBP2 1， 3， and 6 months after surgery in cervical cancer patients gradually decreased， and there were statistical differences in pairwise comparisons at each time point （

0.05）.The area under the curve of serum DCLK1 and LTBP2 for diagnosing cervical cancer were 0.868 and 0.754，respectively，with sensitivity of 86.67% and 78.67

%，specificity of 81.25% and 60.00%，and optimal cutoff values of 1.49 ng/mL and 19.02 μg/mL.The maximum and average elastic modulus of lesion tissue in the cervical cancer group were obviously higher than those in the CIN group （

0.05）. The positive rates of serum DCLK1，serum LTBP2， and transvaginal SWE in the diagnosis of cervical cance were 86.67%，78.67%，and 82.67%，respectively，which were consistent with the gold standard （

Kappa

=0.624， 0.501，0.673，

0.001），and the positive rate of the combination of them in the diagnosis of cervical cancer was 97.33%，which was highly consistent with the gold standard （

Kappa

=0.846，

0.001）.The sensitivity and accuracy of the three combined diagnosis were obviously higher than those of the single indicator diagnosis of serum DCLK1， LTBP2， and transvaginal SWE， the specificity of the three combined diagnosis was obviously higher than that of the single indicator diagnosis of serum DCLK1 and LTBP2， the misdiagnosis rate of the three combined diagnosis was obviously lower than that of the single indicator diagnosis of serum DCLK1 and LTBP2， and the differences were all statistically significant （

0.05）.

Conclusion

Serum DCLK1 and LTBP2 combined with transvaginal SWE has high application value in the diagnosis of cervical cancer， which can further improve the sensitivity and accuracy of diagnosis， and reduce the misdiagnosis rate.

关键词

双皮质素样激酶1潜在转化生长因子结合蛋白2经阴道实时剪切波弹性成像宫颈癌

Keywords

double cortin-like kinase 1latent transforming growth factor binding protein 2transvaginal real-time shear wave elastographycervical cancer

references

Sharma S，Deep A，Sharma AK.Current treatment for cervical cancer：an update［J］.Anticancer Agents Med Chem，2020，20（15）：1768-1779.doi：10.2174/1871520620666200224093301http://dx.doi.org/10.2174/1871520620666200224093301.

Ditto A，Bogani G，Maggiore ULR，et al.Oncologic effectiveness of nerve-sparing radical hysterectomy in cervical cancer［J］.J Gynecol Oncol，2018，29（3）：104-107.doi：10.3802/jgo.2018.29.e41http://dx.doi.org/10.3802/jgo.2018.29.e41.

陈斌，钟彝璞.PET-CT融合显像技术在宫颈癌术前分期诊断中的应用价值［J］.中国CT和MRI杂志，2021，19（12）：124-126.doi：10.3969/j.issn.1672-5131.2021.12.038http://dx.doi.org/10.3969/j.issn.1672-5131.2021.12.038.

张惠敏，叶新华，刘辉，等.经阴道实时剪切波弹性成像技术联合阴道镜检查在宫颈癌中的诊断应用［J］.河北医药，2022，44（2）：272-274.doi：10.3969/j.issn.1002-7386.2022.02.030http://dx.doi.org/10.3969/j.issn.1002-7386.2022.02.030.

李伟枫，林铁成，谢咏，等.血清miR-15b、DCLK1水平与宫颈癌患者临床病理特征及预后的关系［J］.山东医药，2021，61（28）：19-22.doi：10.3969/j.issn.1002-266X.2021.28.005http://dx.doi.org/10.3969/j.issn.1002-266X.2021.28.005.

唐固平，李昭会，陈丽融，等.潜在转化生长因子结合蛋白2在老年宫颈癌病人血清中的表达及临床意义［J］.实用老年医学，2021，35（5）：483-486.doi：10.3969/j.issn.1003-9198.2021.05.013http://dx.doi.org/10.3969/j.issn.1003-9198.2021.05.013.

李静，索红燕，孔为民.《国际妇产科联盟（FIGO）2018癌症报告：宫颈癌新分期及诊治指南》解读［J］.中国临床医生杂志，2019，47（6）：646-649.doi：10.3969/j.issn.2095-8552.2019.06.008http://dx.doi.org/10.3969/j.issn.2095-8552.2019.06.008.

郎景和.子宫颈上皮内瘤变的诊断与治疗［J］.中华妇产科杂志，2001，9（5）：340-341.doi：10.3969/j.issn.1672-2876.2011. 05.013http://dx.doi.org/10.3969/j.issn.1672-2876.2011.05.013.

黄晨，杨悦，李红侠.宫颈上皮内瘤变患者血清和病灶中HLA-E、HLA-G表达与临床病理特征及术后复发的关系分析［J］.中国计划生育和妇产科，2022，14（5）：72-77.doi：10.3969/j.issn.1674-4020.2022.05.20http://dx.doi.org/10.3969/j.issn.1674-4020.2022.05.20.

Hayakawa Y，Sakitani K，Konishi M，et al.Nerve growth factor promotes gastric tumorigenesis through aberrant cholinergic signaling［J］.Cancer Cell，2017，31（1）：21-34.doi：10.1016/j.ccell.2016. 11.005http://dx.doi.org/10.1016/j.ccell.2016.11.005.

Li J，Wang Y，Ge J，et al.Doubl ecortin-like kinase I （DCLK1） regulates B cell-specific moloney murine leukemia virus insertion site 1 （Bmi-1） and is associated with metastasis and prognosis in pancreatic cancer［J］.Cell Physiol Biochem，2018，51（1）：262-277.doi：10.1159/000495228http://dx.doi.org/10.1159/000495228.

Cheng L，Huang S，Chen L，et al.Research progress of DCLK1 inhibitors as cancer therapeutics［J］.Curr Med Chem，2022，29（13）：2261-2273.doi：10.2174/0929867328666210709110721http://dx.doi.org/10.2174/0929867328666210709110721.

王雯智，郑蕾，李虹.宫颈癌中miR-15b、DCLK1的表达变化及与放疗敏感性的关系［J］.河北医药，2020，42（3）：330-334.doi：10.3969/j.issn.1002-7386.2020.03.002http://dx.doi.org/10.3969/j.issn.1002-7386.2020.03.002.

于晓，白睿华，李修炜，等.局部晚期宫颈癌患者血清双肾上腺素样激酶1、黏蛋白1的表达及与放疗预后的关系［J］.癌症进展，2023，21（7）：728-731.doi：10.11877/j.issn.1672-1535.2023.21.07.08http://dx.doi.org/10.11877/j.issn.1672-1535.2023.21.07.08.

Kim JH，Park SY，Jeon SE，et al.DCLK1 promotes colorectal cancer stemness and aggressiveness via the XRCC5/COX2 axis［J］.Theranostics，2022，12（12）：5258-5271.doi：10.7150/thno.72037http://dx.doi.org/10.7150/thno.72037.

Wang T，Zhou Z，Wang C，et al.LTBP2 knockdown promotes ferroptosis in gastric cancer cells through p62-Keap1-Nrf2 pathway［J］.Biomed Res Int，2022：6532253.doi：10.1155/2022/6532253http://dx.doi.org/10.1155/2022/6532253.

Zhao J，Liu X，Cong K，et al.The prognostic significance of LTBP2 for malignant tumors：evidence based on 11 observational studies［J］.Medicine （Baltimore），2022，101（17）：e29207.doi：10.1097/MD. 0000000000029207http://dx.doi.org/10.1097/MD.0000000000029207.

叶玲红，杨惠芬，程烨.经阴道超声联合经腹超声诊断宫颈癌的临床研究［J］.中国现代医生，2019，57（25）：109-112.doi：10.3969/j.issn.1672-5131.2019.02.025http://dx.doi.org/10.3969/j.issn.1672-5131.2019.02.025.

来利娟，姚胜银，王圣明，等.MRI、经阴道彩色多普勒超声联合检测宫颈癌的诊断效能研究［J］.中国CT和MRI杂志，2021，19（7）：118-120.doi：10.3969/j.issn.1672-5131.2021.07.037http://dx.doi.org/10.3969/j.issn.1672-5131.2021.07.037.

李小利，姜培娟，朱雪华.经阴道实时剪切波弹性成像联合癌胚抗原和糖类抗原125检测在早期宫颈癌诊断中的应用价值［J］.中国妇幼保健，2022，37（14）：2694-2697.doi：10.19829/j.zgfybj.issn. 1001-4411.2022.14.046http://dx.doi.org/10.19829/j.zgfybj.issn.1001-4411.2022.14.046.

曾曼婷，周宁波，刘继华，等.实时剪切波弹性成像对子宫颈癌前病变及子宫颈癌的诊断价值［J］.实用妇产科杂志，2019，35（8）：629-632.

陶玉华，缪娴，纪红娟，等.SWE检查联合氯离子通道蛋白-3在诊断宫颈癌中的应用［J］.影像科学与光化学，2023， 41（1）： 142-146.doi： 10.7517/issn.1674-0475.221035http://dx.doi.org/10.7517/issn.1674-0475.221035.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

FOXM1上调ELK1介导铁死亡促进宫颈癌细胞顺铂耐药性

SKA2对宫颈癌细胞增殖、迁移和侵袭的影响及其预后价值

miR-30d-5p对宫颈癌细胞生长和转移的影响

精准膜解剖下保留盆腔自主神经宫颈癌根治术疗效观察

hsa_circ_0011946靶向miR-767-3p调控宫颈癌细胞增殖、迁移和侵袭