Comparison of dynamic contrast-enhanced-magnetic resonance imaging parameters and serum markers in preoperative rectal cancer evaluation: Combined diagnostic value

Table 1 Comparison of demographic and clinical characteristics among rectal cancer patients by T stage, mean ± SD/n (%)

Group	Early-stage group (n = 72)	Late-stage group (n = 54)	t/χ²	P value
Age (year)	58.25 ± 10.32	59.46 ± 11.24	0.629	0.531
Sex			0.382	0.537
Male	42 (58.33)	29 (53.70)
Female	30 (41.67)	25 (46.30)
BMI (kg/m²)	23.45 ± 3.21	23.82 ± 3.15	0.643	0.521
KPS score	85.62 ± 7.85	84.93 ± 8.12	0.483	0.630
Smoke			0.295	0.587
Yes	31 (43.06)	26 (48.15)
No	41 (56.94)	28 (51.85)
Alcohol			0.428	0.513
Yes	28 (38.89)	24 (44.44)
No	44 (61.11)	30 (55.56)
Hypertension			0.317	0.573
Yes	25 (34.72)	22 (40.74)
No	47 (65.28)	32 (59.26)
Diabetes			0.394	0.530
Yes	18 (25.00)	16 (29.63)
No	54 (75.00)	38 (70.37)
Family history			0.273	0.601
Yes	12 (16.67)	11 (20.37)
No	60 (83.33)	43 (79.63)
Tumor location			0.518	0.772
Upper section	24 (33.33)	16 (29.63)
Middle section	28 (38.89)	24 (44.44)
Lower section	20 (27.78)	14 (25.93)
Differentiation degree			1.386	0.239
Low differentiation	25 (34.72)	24 (44.44)
Medium to high differentiation	47 (65.28)	30 (55.56)

BMI: Body mass index; KPS: Karnofsky performance status.

Table 2 Comparison of general information of rectal cancer patients, mean ± SD/n (%)

Group	Early-stage group (n = 49)	Late-stage group (n = 77)	t/χ²	P value
Age (year)	58.92 ± 10.85	58.63 ± 10.68	0.147	0.883
Sex			0.286	0.593
Male	29 (59.18)	42 (54.55)
Female	20 (40.82)	35 (45.45)
BMI (kg/m²)	23.56 ± 3.18	23.64 ± 3.20	0.138	0.891
KPS score	85.12 ± 8.02	85.48 ± 7.92	0.252	0.801
Smoke			0.317	0.573
Yes	24 (48.98)	33 (42.86)
No	25 (51.02)	44 (57.14)
Alcohol			0.394	0.530
Yes	22 (44.90)	30 (38.96)
No	27 (55.10)	47 (61.04)
Hypertension			0.273	0.601
Yes	19 (38.78)	28 (36.36)
No	30 (61.22)	49 (63.64)
Hypertension			0.328	0.567
Yes	14 (28.57)	20 (25.97)
No	35 (71.43)	57 (74.03)
Family history			0.295	0.587
Yes	10 (20.41)	13 (16.88)
No	39 (79.59)	64 (83.12)
Tumor location			0.482	0.786
Upper section	15 (30.61)	25 (32.47)
Middle section	21 (42.86)	31 (40.26)
Lower section	13 (26.53)	21 (27.27)

BMI: Body mass index; KPS: Karnofsky performance status.

Table 3 Analysis of receiver operating characteristic curves

Evaluation factors	AUC	95%CI	Threshold value	True positive rate	Selectivity	Yoden
T installment
Ktrans	0.835	0.762-0.908	0.286	79.825	75.632	0.555
Ve	0.812	0.736-0.888	0.375	77.234	73.521	0.508
DCE-MRI parameters	0.892	0.832-0.952	0.462	85.763	81.924	0.677
Degree of differentiation
Ktrans	0.821	0.748-0.894	0.273	78.632	74.825	0.535
Ve	0.803	0.728-0.878	0.362	76.523	72.934	0.495
DCE-MRI parameters	0.883	0.821-0.945	0.453	84.925	80.763	0.657

DCE-MRI: Dynamic contrast-enhanced magnetic resonance imaging; Ktrans: Volume transfer constant; Ve: Volume fraction of extravascular extracellular space; AUC: Area under the curve; CI: Confidence interval.

Table 4 Analysis of receiver operating characteristic curves

Evaluation factors	AUC	95%CI	Threshold	True positive rate	Selectivity	Yoden
T installment
CA19-9	0.812	0.736-0.888	37.253	78.523	73.465	0.520
CA125	0.798	0.723-0.873	32.864	76.352	71.923	0.483
DCE-MRI indicators and cancer markers	0.923	0.865-0.981	0.526	89.734	85.623	0.754
Degree of differentiation
CA19-9	0.803	0.728-0.878	35.921	77.462	72.845	0.503
CA125	0.785	0.711-0.859	31.532	75.283	70.942	0.462
DCE-MRI parameters + tumor markers	0.912	0.855-0.969	0.512	88.653	84.372	0.730

DCE-MRI: Dynamic contrast-enhanced magnetic resonance imaging; CA: Carbohydrate antigen; AUC: Area under the curve; CI: Confidence interval.

Table 5 DeLong test results for the area under the curve of dynamic contrast-enhanced magnetic resonance imaging metrics and tumor biomarkers in differentiating T staging and degree of differentiation

Inspection results	Z-score	Significance level	AUC	Mean error	95%CI
T installment
CA19-9 and CA125 serum biomarkers	0.862	0.389	0.014	0.016	-0.018 to 0.046
CA19-9 alongside DCE-MRI measurements and cancer markers	4.253	< 0.05	0.111	0.026	0.060 to 0.162
CA125 in conjunction with DCE-MRI parameters and tumor markers	4.682	< 0.05	0.125	0.027	0.072 to 0.178
Degree of differentiation
CA19-9 and CA125 serum biomarkers	0.923	0.356	0.018	0.020	-0.021 to 0.057
CA19-9 alongside DCE-MRI measurements and cancer markers	4.132	< 0.05	0.109	0.026	0.058 to 0.160
CA125 in conjunction with DCE-MRI parameters and tumor markers	4.521	< 0.05	0.127	0.028	0.072 to 0.182

DCE-MRI: Dynamic contrast-enhanced magnetic resonance imaging; CA: Carbohydrate antigen; AUC: Area under the curve; CI: Confidence interval.