FIGOⅠA期子宫内膜样腺癌病理组织分化程度与MRI定量、半定量灌注参数、Ki-67、CA12-5的相关性研究  

The Correlation Study of the Differentiation Degree of the Pathological Tissue of FIGOⅠA Stage Endometrioid Adenocarcinoma with MRI Quantitative,Semi-Quantitative Perfusion Parameters,Ki-67,CA12-5

作　　者：张虎[1] 沈善昌 李霞[2] 张强[1] 李金玲[3] ZHANG Hu;SHEN Shanchang;LI Xia(Department of Radiology,The Affiliated Hospital of Binzhou Medical College,Binzhou,Shandong Province 256603,P.R.China)

机构地区：[1]滨州医学院附属医院放射科,256603 [2]滨州医学院附属医院妇产科,256603 [3]滨州医学院附属医院检验科,256603

出　　处：《临床放射学杂志》2021年第8期1610-1615,共6页Journal of Clinical Radiology

摘　　要：目的探讨国际妇产科协会(FIGO)ⅠA期子宫内膜样腺癌病理特征与磁共振灌注参数、血清肿瘤标记物的相关性。方法搜集35例首诊经病理证实为FIGOⅠA期子宫内膜样腺癌患者。所有患者均行3.0 T磁共振灌注扫描,测得肿瘤感兴趣区(ROI)的定量灌注参数值:容积转运常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积分数(Ve);半定量参数:初始增强曲线下面积(IAUCG)、最大增强斜率(MaxSlope)、对比增强比率(CER)。应用统计学方法分析子宫内膜样腺癌不同病理组织分化程度与磁共振灌注参数、Ki-67、CA12-5的相关性。结果Ktrans值、Kep值、MaxSlope值、CER值及Ki-67、CA12-5在不同分化程度的子宫内膜癌中均有统计学差异(P<0.05),Ve值、IAUCG值在不同分化程度的差异不具有统计学意义。受试者工作特征(ROC)曲线分析得出Kep值对应的曲线下面积(AUC)最大(AUC为0.955)。Spearman相关分析Ktrans值、Kep值、CER值与子宫内膜癌分化程度呈中等程度正相关;MaxSlope值和CA12-5与子宫内膜癌分化程度呈低等程度正相关。Ktrans值、Kep值与Ki-67值呈中等程度正相关,CA12-5与Ki-67值呈低等程度正相关。结论MRI灌注参数和血清CA12-5有助于评估ⅠA期子宫内膜腺癌的病理组织学分级特征。Objective To explore the correlation between the pathological characteristics of FIGOⅠA endometrioid adenocarcinoma,magnetic resonance perfusion parameters and serum tumor markers.Methods Collected the data of 35 patients with FIGO stageⅠA endometrioid adenocarcinoma confirmed by pathology.All patients underwent 3.0 T magnetic resonance perfusion scan,and the quantitative perfusion parameters of the tumor area of interest were measured:volume transfer constant(Ktrans),reverse reflux rate constant(Kep),volume fraction of EES(Ve);semi-quantitative parameters:initial region under Gd concentration time curve(IAUCG),maximum slope(MaxSlope),contrast enhancement ratio(CER).Statistical methods were used to analyze the correlation between the degree of differentiation of endometrioid adenocarcinoma and MRI perfusion parameters,and Ki-67,CA12-5.Results Ktrans,Kep,MaxSlope,CER,Ki-67 and CA12-5 were statistically different in endometrial carcinomas of different levels of differentiation(P<0.05),while the differences of Veand IAUCG at different levels of differentiation were not statistically significant.ROC curve analysis showed that the area under the curve corresponding to Kepwas the largest(0.955).Spearman correlation analysis Ktrans,Kep,CER weremoderate positively correlated with the differentiation of endometrial cancer;MaxSlope,CA12-5 was low positively correlated with the differentiation of endometrial cancer.Ktrans,Kepand Ki-67 werepositively correlated with a moderate degree,CA12-5 and Ki-67 werepositively correlated with a low degree.Conclusion MRI perfusion parameters and CA12-5 help to evaluate the histopathological grading characteristics of stageⅠA endometrial adenocarcinoma.

关 键 词：国际妇产科协会ⅠA期 子宫内膜样腺癌 组织学分级 磁共振灌注成像 KI-67 CA12-5 

分 类 号：R737.33[医药卫生—肿瘤]