乳腺癌磁共振表观扩散系数与Ki-67表达的相关性  

Correlation between MRI apparent diffusion coefficient value and Ki-67 index in patients with breast cancer

作　　者：顾磊 夏进东[1] 饶圣祥 陈财忠 GU Lei;XIA Jin-dong;RAO Sheng-xiang;CHEN Cai-zhong(Department of Radiology, Central Hospital of Songjiang, Shanghai 201600, China;Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Imaging Medicine, Shanghai 200032, China)

机构地区：[1]上海市松江区中心医院放射科,上海201600 [2]复旦大学附属中山医院放射科,上海市影像医学研究所,上海200032

出　　处：《中国临床医学》2019年第6期844-847,共4页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨乳腺癌磁共振表观扩散系数(apparent diffusion coefficient,ADC)与Ki-67表达的相关性。方法:回顾性分析120例经手术证实的乳腺癌术前扩散加权成像(diffusion weighted imaging,DWI)的磁共振影像(b=0、800、1000 s/mm2),并测量其ADC值,分析ADC值与Ki-67指数的相关性。根据Ki-67指数的不同分为A组(低Ki-67组,n=60)和B组(高Ki-67组,n=60),比较两组间的ADC值并采用受试者工作特征(receiver operating characteristics,ROC)曲线分析ADC值鉴别诊断价值。结果:乳腺癌测量的ADC值与Ki-67指数明显负相关(rb值800=-0.587,rb值1000=-0.63,P<0.0001)。相同b值下,B组的平均ADC值明显小于A组(P<0.0001)。b值为1000 s/mm2时的平均ADC值小于同组b值800 s/mm2的平均ADC值。当b值为800、1000 s/mm2时,分别以ADC值1954.00、1521.00(10-6 mm2/s)为临界值,鉴别诊断A、B组乳腺癌的ROC曲线下面积分别为0.91、0.94,敏感度分别为73.30%、83.00%,特异度分别为95.00%、91.70%。结论:MRI ADC值与乳腺癌Ki-67指数表达明显相关,值得进一步研究以应用于临床指导乳腺癌术前诊治。Objective:To explore the relationship between MRI apparent diffusion coefficient(ADC)value and Ki-67 index in patients with breast cancer.Methods:The preoperative MRI diffusion weighted imaging(DWI)images(b=0,800,1000 s/mm)of 120 patients with surgically confirmed breast cancer were retrospectively analyzed,and the ADC values were measured.The correlation between the ADC value and Ki-67 index was analyzed.According to the different Ki-67 index,they were divided into group A(low Ki-67 group,n=60)and group B(high Ki-67 group,n=60).ADC values between the two groups were compared and the identification ability of ADC value was analyzed by receiver operating characteristics(ROC)curve.Results:The ADC value of breast cancer was negatively correlated with Ki-67 index(r=-0.587,r=-0.63,P<0.0001).Under the same B value,the average ADC value of group B was significantly lower than that of group A(P<0.0001).When b value was 1000 s/mm,the average ADC value was lower than that of 800 s/mm in the same group.When the b value was 800 or 1000 s/mm,using 1954.00 or 1521.00(10 s/mm)as the critical ADC values respectively,the area under the ROC curve for differential diagnosis of breast cancer in group A and B was 0.91 or 0.94,respectively.The sensitivity was 73.30%or 83.00%,and the specificity was 95.00%or 91.70%,respectively.Conclusions:ADC value has an important predictive value for the expression of Ki-67 index in patients with breast cancer.

关 键 词：乳腺癌 表观扩散系数 KI-67指数 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤]