直肠癌磁共振体素内不相干运动成像定量参数与Ki-67表达水平的相关性分析  

Relationship between parameters of intravoxel incoherent motion imaging with Ki-67 expression level in rectal adenocarcinoma

作　　者：朱海滨[1] 李晓婷[1] 刘玉良[1] 孙应实[1] ZHU Haibin LI Xiaoting LIU Yuliang SUN Yingshi(Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research , Peking University Cancer Hospital ＆ Institute, Beijing 100142, China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国医学影像技术》2017年第2期237-241,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(8147164081371715)

摘　　要：目的探讨直肠癌体素内不相干运动成像(IVIM)定量参数值与Ki-67表达水平的相关性。方法 86例未接受新辅助治疗而直接经手术证实的直肠腺癌患者接受直肠多b值DWI检查(b=0、20、50、100、200、400、600、800、1 000、1 200、1 400、1 600s/mm^2),测量病灶相应的D、D*、f值。按Ki-67水平将其分为低表达组(Ki-67<50%)和高表达组(Ki-67≥50%),比较两组多b值定量参数有无差异并分析其与Ki-67表达水平的相关性,并采用多因素回归分析Ki-67指数增殖程度与临床病理结果和MR参数的关系。结果直肠癌低表达组与高表达组的平均D、f值分别为[(0.61±0.14)×10^(-3) mm^2/s vs(0.44±0.15)×10^(-3) mm^2/s;(0.25±0.07)vs(0.32±0.10)],差异有统计学意义(P<0.01;P=0.01),两组间D*值差异无统计学意义[(24.2±8.9)×10^(-3) mm^2/s vs(23.5±12.1)×10^(-3) mm^2/s,P=0.41]。D值与Ki-67表达水平呈负相关(r=-0.40,P<0.01)。多因素回归分析提示仅D值是高Ki-67表达的独立危险因子。结论直肠癌D值与Ki-67表达相关,可间接评估直肠肿瘤细胞增殖情况及预后,反映直肠癌的侵袭性和生物学特性。Objective To explore the relationship between parameters of intravoxel incoherent motion imaging and the molecular markers Ki-67 in rectal cancer patients.Methods Totally 86 patients with rectal cancer confirmed by surgery and without receiving chemoradiotherapy were included in this retrospective study.All patients underwent multiple b-values（b=0,20,50,100,200,400,600,800,1 000,1 200,1 400,1 600s/mm^2）DWI before any anticancer treatment.The patients were divided into low Ki-67group（Ki-6750%）and high Ki-67group（Ki-67≥50%）according to Ki-67 level.Relationship between the quantitative parameters from IVIM model and Ki-67 level were assessed.The relationship among Ki-67 level,clinicopathological outcomes and MR parameters was analyzed using linear regression analysis.Results In high Ki-67 group,the mean D,f value had significantly differences compared with those of the low-Ki-67group[（0.61±0.14）×10^（-3） mm^2/s vs（0.44±0.15）×10^（-3） mm^2/s,P〈0.01;（0.25±0.07）vs（0.32±0.10）,P=0.01].However,the mean D＊values had no difference between two groups（[24.2±8.9]×10^（-3） mm^2/s vs[23.5±12.1]×10^（-3） mm^2/s,P=0.41）.There was a negative correlation between Ki-67 level and D values（r=-0.40,P〈0.01）.In addition,of all these variables,a higher D values independently predicted a high Ki-67 status.Conclusion Significant correlations are observed between pre-treatment D values and Ki-67 level of rectal cancer.It suggests that D value from IVIM model may be used as a noninvasive biomarker for evaluation the biological features of rectal cancer before treatment.

关 键 词：直肠肿瘤 体素内不相干运动 扩散加权成像 KI-67 

分 类 号：R735.3[医药卫生—肿瘤] R445.2[医药卫生—临床医学]