血清DCLK1、WISP1联合MRI对宫颈癌的诊断价值-东南大学学报医学版

血清DCLK1、WISP1联合MRI对宫颈癌的诊断价值

单位：1. 南京医科大学第四附属医院放射科, 江苏南京 211800;
2. 南京医科大学第四附属医院妇产科, 江苏南京 211800

分类号：R737.33

出版年·卷·期（页码）：2025·44·第六期（960-966）

摘要：

目的: 探讨血清双皮质素样激酶1(DCLK1)、WNT1诱导信号通路蛋白1(WISP1)联合磁共振成像(MRI)对宫颈癌(CC)的诊断价值。方法: 选取2020年1月至2023年10月本院收治的CC患者280例,所有患者均行MRI检测,根据宫旁浸润分为浸润和非浸润组,根据盆腔淋巴结转移分为转移组和非转移组。酶联免疫吸附法(ELISA)检测DCLK1、WISP1水平;采用受试者工作特征(ROC)曲线分析血清DCLK1、WISP1联合MRI对CC宫旁浸润以及盆腔淋巴结转移的临界诊断点;四格表分析血清DCLK1、WISP1联合MRI对CC宫旁浸润以及盆腔淋巴结转移的诊断价值;Kappa分析诊断的一致性。结果: 与非浸润组相比,浸润组血清DCLK1、WISP1水平及MRI阳性率升高(P＜0.05)。根据ROC曲线得知,血清DCLK1、WISP1、MRI诊断CC宫旁浸润的AUC分别为0.791、0.829、0.855,三者联合诊断CC宫旁浸润的AUC为0.966。血清DCLK1、WISP1、MRI诊断CC宫旁浸润准确度分别为83.93%、83.21%、88.21%;三者联合检测CC宫旁浸润准确度为93.93%。血清DCLK1、WISP1、MRI单独及联合诊断CC宫旁浸润的Kappa值分别为0.602、0.584、0.708、0.850。转移组血清DCLK1、WISP1水平及MRI阳性率显著高于非转移组(P＜0.05)。根据ROC曲线得知,血清DCLK1、WISP1、MRI诊断CC盆腔淋巴结转移的AUC分别为0.831、0.777、0.867,三者联合诊断CC盆腔淋巴结转移的AUC为0.963。血清DCLK1、WISP1、MRI诊断CC盆腔淋巴结转移准确度分别为84.64%、83.21%、89.64%;三者联合检测CC盆腔淋巴结转移准确度为94.64%。血清DCLK1、WISP1、MRI单独及联合诊断CC盆腔淋巴结转移的Kappa值分别为0.600、0.563、0.730、0.860。结论: 血清DCLK1、WISP1联合MRI可准确诊断CC宫旁浸润以及盆腔淋巴结转移情况。

Objective: To investigate the diagnostic value of serum double corticogen-like kinase 1(DCLK1) and WNT1-inducible signaling pathway protein 1(WISP1) combined with magnetic resonance imaging(MRI) in the diagnosis of cervical cancer(CC). Methods: A total of 280 CC patients admitted to our hospital from January 2020 to October 2023 were selected, and all patients were divided into infiltrating and non-infiltrating groups according to parauterine invasion, and metastatic and non-metastatic groups according to pelvic lymph node metastasis. Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of DCLK1 and WISP1. Receiver operating characteristic(ROC) curve analysis of serum DCLK1 and WISP1 combined with MRI was used to determine the critical diagnostic point for parametrial infiltrate and pelvic lymph node metastasis in CC. The value of serum DCLK1 and WISP1 combined with MRI in the diagnosis of CC parametrial infiltrates and pelvic lymph node metastasis was analyzed by a four-grid table; The diagnostic consistency was analysed by Kappa. Results: Compared with the non-infiltrating group, the serum levels of DCLK1 and WISP1 and the positive rate of MRI in the infiltrating group were increased(P<0.05). According to the ROC curve, the AUC of serum DCLK1, WISP1 and MRI in the diagnosis of CC parametrial infiltrate were 0.791, 0.829 and 0.855, respectively.And the AUC of joint detection of CC parametrial infiltrate was 0.966. The accuracy of serum DCLK1, WISP1 and MRI in diagnosing CC parametrial infiltrates were 83.93%, 83.21% and 88.21%, respectively. The accuracy of the joint detection of CC parametrial infiltrates was 93.93%. Kappa values for serum DCLK1, WISP1, and MRI alone and in combination for the diagnosis of CC parietal infiltrates were 0.602, 0.584, 0.708, and 0.850, respectively. The serum levels of DCLK1, WISP1 and MRI positive rate in the metastatic group were significantly higher than those in the non-metastatic group(P<0.05). According to the ROC curve, the AUC of serum DCLK1, WISP1 and MRI in the diagnosis of CC pelvic lymph node metastasis was 0.831, 0.777 and 0.867, respectively. And the AUC of joint detection of CC pelvic lymph node metastasis was 0.963. The accuracy of serum DCLK1, WISP1 and MRI in diagnosing CC pelvic lymph node metastasis were 84.64%, 83.21% and 89.64%, respectively. The accuracy of the joint detection of CC pelvic lymph node metastasis was 94.64%.Kappa values for serum DCLK1, WISP1, and MRI alone and in combination for the diagnosis of CC pelvic lymph node metastasis were 0.600, 0.563, 0.730, and 0.860, respectively. Conclusion: Serum DCLK1 and WISP1 combined with MRI can accurately diagnose CC parauterine infiltrates and pelvic lymph node metastasis.

参考文献：

[1] VIVEROS-CARREÑO D,FERNANDES A,PAREJA R.Updates on cervical cancer prevention[J].Int J Gynecol Cancer,2023,33(3):394-402.
[2] 徐宁,张慧,王君,等.经阴道超声RTE联合经阴道常规超声诊断宫颈癌的价值[J].东南大学学报(医学版),2024,43(2):224-228.
[3] 邱毅,江林,李仕广,等.高分辨率MRI联合DCE-MRI对老年宫颈癌的诊断价值[J].中国老年学杂志,2022,42(16):3940-3942.
[4] WANG M,PERUCHO J A U,TSE K Y,et al.MRI texture features differentiate clinicopathological characteristics of cervical carcinoma[J].Eur Radiol,2020,30(10):5384-5391.
[5] 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):19-22,27.
[6] 向慧敏,李筱,饶琴琴,等.宫颈癌患者血清双皮质素样激酶1、黏蛋白-1、血管生成素-2的表达及临床意义[J].检验医学与临床,2023,20(5):655-659.
[7] LI Y,WANG F,LIU T,et al.WISP1 induces ovarian cancer via the IGF1/αvβ3/Wnt axis[J].J Ovarian Res,2022,15(1):94.
[8] MARTH C,LANDONI F,MAHNER S,et al.Cervical cancer:ESMO Clinical Practice Guidelines for diagnosis,treatment and follow-up[J].Ann Oncol,2017,28(suppl_4):iv72-iv83.
[9] POPALIS M L,RAMIREZ S I,LEACH K M,et al.Improving cervical cancer screening rates:a scoping review of resources and interventions[J].Cancer Causes Control,2022,33(11):1325-1333.
[10] PRECI D P,ALMEIDA A,WEILER A L,et al.Oxidative damage and antioxidants in cervical cancer[J].Int J Gynecol Cancer,2021,31(2):265-271.
[11] 陈林龙.HPV E6/E7 mRNA联合薄层液基细胞学检测在宫颈癌筛查中的应用价值[J].中国妇幼保健,2020,35(20):3885-3887.
[12] ZHANG J,LIU X.MRI is more valuable than CT in the diagnosis of cervical cancer[J].Am J Transl Res,2023,15(4):2970-2976.
[13] 魏荣富,陈晓萍.MRI联合血清SCCA、CA125对宫颈癌的诊断意义[J].中国CT和MRI杂志,2020,18(7):97-99.
[14] 洪士彬,程杰军,狄文,等.MRI在宫颈癌分期评估中的临床应用及研究进展[J].国际妇产科学杂志,2021,48(6):634-638.
[15] KIM J H,PARK S Y,JEON S E,et al.DCLK1 promotes colorectal cancer stemness and aggressiveness via the XRCC5/COX2 axis[J].Theranostics,2022,12(12):5258-5271.
[16] KALANTARI E,RAZMI M,TAJIK F,et al.Oncogenic functions and clinical significances of DCLK1 isoforms in colorectal cancer:a systematic review and meta-analysis[J].Cancer Cell Int,2022,22(1):217.
[17] 王雯智,郑蕾,李虹,等.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.
[18] 安淑香,雷丽,孙硼朋,等.DCLK1和Snail在三阴性乳腺癌组织中的表达及临床意义[J].标记免疫分析与临床,2021,28(7):1161-1164.
[19] CHANG K S,CHEN S T,SUNG H C,et al.WNT1 inducible signaling pathway protein 1 is a stroma-specific secreting protein inducing a fibroblast contraction and carcinoma cell growth in the human prostate[J].Int J Mol Sci,2022,23(19):11437.
[20] FANG F,XU W,ZHANG J,et al.Ultrasound microbubble-mediated RNA interference targeting WNT1 inducible signaling pathway protein 1(WISP1) suppresses the proliferation and metastasis of breast cancer cells[J].Bioengineered,2022,13(4):11050-11060.
[21] LI B,GUO X,LI N,et al.WNT1,a target of miR-34a,promotes cervical squamous cell carcinoma proliferation and invasion by induction of an E-P cadherin switch via the WNT/β-catenin pathway[J].Cell Oncol,2020,43(3):489-503.
[22] 江美娇,刘帅婷,曾宇晖,等.宫颈癌患者血清WNT1诱导信号通路蛋白1、瞬时受体电位阳离子通道亚家族M成员7水平及临床意义[J].癌症进展,2023,21(18):2006-2009.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录