Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. May 15, 2024; 16(5): 1796-1807
Published online May 15, 2024. doi: 10.4251/wjgo.v16.i5.1796
Diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging parameters and serum tumor markers in rectal carcinoma prognosis
Ren-Qi Mu, Jun-Wei Lv, Cai-Yun Ma, Xiao-Hui Ma, Dong Xing, Hou-Sheng Ma
Ren-Qi Mu, Department of Radiology, Yantai Mountain Hospital, Yantai 264001, Shandong Province, China
Jun-Wei Lv, Dong Xing, Hou-Sheng Ma, Department of Radiology, Yantai Yuhuangding Hospital, Yantai 264000, Shandong Province, China
Cai-Yun Ma, Department of Gynaecology, Yantai Yuhuangding Hospital, Yantai 264000, Shandong Province, China
Xiao-Hui Ma, The First Clinical Medical College, Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
Co-first authors: Ren-Qi Mu and Jun-Wei Lv.
Author contributions: Mu RQ and Lv JW contributed equally to this work and are co-first authors; Mu RQ, Lv JW and Ma HS designed the research and wrote the first manuscript; Mu RQ, Lv JW, Ma CY, Ma XH, Xing D and Ma HS contributed to conceiving the research and analyzing data; Mu RQ and Lv JW conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethic Committee of Yantai Yuhuangding Hospital (2023-297).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: All data and materials are available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hou-Sheng Ma, BMed, Doctor, Department of Radiology, Yantai Yuhuangding Hospital, No. 20 Yuhuangding East Road, Zhifu District, Yantai 264000, Shandong Province, China. mahousheng1971@163.com
Received: December 12, 2023
Peer-review started: December 12, 2023
First decision: January 2, 2024
Revised: January 15, 2024
Accepted: February 29, 2024
Article in press: February 29, 2024
Published online: May 15, 2024
Processing time: 149 Days and 5.2 Hours
Abstract
BACKGROUND

Rectal carcinoma (RC), one of the most common malignancies globally, presents an increasing incidence and mortality year by year, especially among young people, which seriously affects the prognosis and quality of life of patients. At present, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters and serum carbohydrate antigen 19-9 (CA19-9) and CA125 Levels have been used in clinical practice to evaluate the T stage and differentiation of RC. However, the accuracy of these evaluation modalities still needs further research. This study explores the application and value of these methods in evaluating the T stage and differentiation degree of RC.

AIM

To analyze the diagnostic performance of DCE-MRI parameters combined with serum tumor markers (TMs) in assessing pathological processes and prognosis of RC patients.

METHODS

A retrospective analysis was performed on 104 RC patients treated at Yantai Yuhuangding Hospital from May 2018 to January 2022. Patients were categorized into stages T1, T2, T3, and T4, depending on their T stage and differentiation degree. In addition, they were assigned to low (L group) and moderate-high differentiation (M + H group) groups based on their differentiation degree. The levels of DCE-MRI parameters and serum CA19-9 and CA125 in different groups of patients were compared. In addition, the value of DCE-MRI parameters [volume transfer constant (Ktrans), rate constant (Kep), and extravascular extracellular volume fraction (Ve) in assessing the differentiation and T staging of RC patients was discussed. Furthermore, the usefulness of DCE-MRI parameters combined with serum CA19-9 and CA125 Levels in the evaluation of RC differentiation and T staging was analyzed.

RESULTS

Ktrans, Ve, CA19-9 and CA125 were higher in the high-stage group and L group than in the low-stage group and M + H Group, respectively (P < 0.05). The areas under the curve (AUCs) of the Ktran and Ve parameters were 0.638 and 0.694 in the diagnosis of high and low stages, respectively, and 0.672 and 0.725 in diagnosing moderate-high and low differentiation, respectively. The AUC of DCE-MRI parameters (Ktrans + Ve) in the diagnosis of high and low stages was 0.742, and the AUC in diagnosing moderate-high and low differentiation was 0.769. The AUCs of CA19-9 and CA-125 were 0.773 and 0.802 in the diagnosis of high and low stages, respectively, and 0.834 and 0.796 in diagnosing moderate-high and low differentiation, respectively. Then, we combined DCE-MRI (Ktrans + Ve) parameters with CA19-9 and CA-125 and found that the AUC of DCE-MRI parameters plus serum TMs was 0.836 in the diagnosis of high and low stages and 0.946 in the diagnosis of moderate-high and low differentiation. According to the Delong test, the AUC of DCE-MRI parameters plus serum TMs increased significantly compared with serum TMs alone in the diagnosis of T stage and differentiation degree (P < 0.001).

CONCLUSION

The levels of the DCE-MRI parameters Ktrans and Ve and the serum TMs CA19-9 and CA125 all increase with increasing T stage and decreasing differentiation degree of RC and can be used as indices to evaluate the differentiation degree of RC in clinical practice. Moreover, the combined evaluation of the above indices has a better effect and more obvious clinical value, providing important guiding importance for clinical condition judgment and treatment selection.

Keywords: Rectal carcinoma, Volume transfer constant, Rate constant, Extravascular extracellular volume fraction, Serum carbohydrate antigen 19-9, Serum carbohydrate antigen 125

Core Tip: This study explored the application and value of dynamic contrast-enhanced magnetic resonance imaging parameters and serum carbohydrate antigen 19-9 (CA19-9) and CA125 Levels in evaluating the T stage and differentiation degree of rectal carcinoma (RC). The results show that these assessment tools have significant predictive ability and may improve the diagnostic accuracy of RC. In addition, our research highlights the importance of a deeper understanding of the biological characteristics and disease progression of RC. The comprehensive use of these tools can help doctors provide more personalized treatment programs for patients and improve patient outcomes.