多层螺旋CT联合血清VEGF、Bcl-2水平诊断食管癌的价值分析

Diagnostic value of multi-slice spiral CT combined with serum VEGF and Bcl-2 levels in esophageal cancer

摘要:

目的 分析多层螺旋CT联合血清血管内皮生长因子（VEGF）、B细胞淋巴瘤2（Bcl-2）水平在食管癌中的诊断价值。方法 选取2019年10月—2020年12月天津医科大学总医院收治的100例疑似食管癌患者作为研究对象。所有患者术前均接受多层螺旋CT（MSCT）检查及VEGF、Bcl-2水平检测。以手术诊断结果为“金标准”，分析MSCT与VEGF、Bcl-2水平联合诊断食管癌的敏感性、特异性及准确性，并比较食管癌不同临床病理特征患者的VEGF、Bcl-2水平。结果 确诊为食管癌的患者86例（恶性组），其余14例患者为良性病变（良性组）。恶性组VEGF、Bcl-2水平高于良性组（P <0.05）；MSCT、VEGF、Bcl-2及联合诊断食管癌的敏感性为84.88%（95%CI：0.698，0.928）、81.40%（95%CI：0.673，0.904）、79.07%（95%CI：0.684，0.899）及94.19%（95%CI：0.885，0.996），特异性为71.43%（95%CI：0.584，0.857）、64.29%（95%CI：0.463，0.689）、57.14%（95%CI：0.440，0.651）及78.57%（95%CI：0.648，0.873），准确性为83.00%（95% CI：0.685，0.912）、79.00%（95% CI：0.663，0.895）、76.00%（95% CI：0.674，0.886）及92.00%（95% CI：0.835，0.985）；不同病灶部位、病理类型患者的VEGF、Bcl-2水平比较，差异无统计学意义（P >0.05）；不同TNM分期、分化程度、肿瘤直径、淋巴结转移患者的VEGF、Bcl-2水平比较，差异有统计学意义（P <0.05）。结论 在MSCT的基础上联合VEGF、Bcl-2水平检测对诊断食管癌具有一定的指导意义，有助于提高诊断的敏感性和准确性。

Abstract:

Objective To analyze the diagnostic value of multi-slice spiral CT combined with serum vascular endothelial growth factor (VEGF) and B cell lymphocyte 2 (Bcl-2) levels in esophageal cancer.Methods A total of 100 patients with suspected esophageal cancer admitted to General Hospital of Tianjin Medical University from October 2019 to December 2020 were selected as the research subjects. All patients received MSCT examination, and VEGF and Bcl-2 levels was recorded before operation. With the surgical diagnosis result as the "gold standard", the sensitivity, specificity, and accuracy of the combined diagnosis of esophageal cancer by MSCT, VEGF and Bcl-2 levels were analyzed, and the levels of VEGF and Bcl-2 in patients with different clinical symptoms of esophageal cancer were compared.Results Among the 100 suspected cases, 86 were diagnosed as esophageal cancer by surgery, and the remaining 14 patients were benign lesions; the levels of VEGF and Bcl-2 in the malignant group were higher than those in the benign group (P < 0.05); the sensitivity of MSCT, VEGF, Bcl-2, and combined diagnosis of esophageal cancer was respectively 84.88% (95% CI: 0.698, 0.928), 81.40% (95% CI: 0.673, 0.904), 79.07% (95% CI: 0.684, 0.899), 94.19% (95% CI: 0.885，0.996), and the specificity was respectively 71.43% (95% CI: 0.584, 0.857）, 64.29% (95% CI: 0.463, 0.689）, 57.14% (95% CI: 0.440, 0.651), 78.57% (95% CI: 0.648，0.873), and the accuracy was respectively 83.00% (95% CI: 0.685, 0.912), 79.00% (95% CI: 0.663, 0.895), 76.00% (95% CI: 0.674, 0.886), 92.00% (95% CI: 0.835, 0.985); there was no significant difference in the levels of VEGF and Bcl-2 in patients with different lesion locations and pathological types (P > 0.05); The levels of VEGF and Bcl-2 in patients with different TNM stages, degree of differentiation, tumor diameter, and lymph node metastasis had significance (P < 0.05).Conclusion MSCT combined with VEGF, BCL-2 level detection has a certain guiding significance in the diagnosis of esophageal cancer, help to improve the diagnostic sensitivity and accuracy.