新辅助化疗前后乳腺癌液实性区表观扩散系数与K-i 67的相关性研究  

Correlation between apparent diffusion coefficient and Ki-67 index during neoadjuvant chemotherapy in breast cancer fluid solid area

作　　者：赵阳[1] 王琛[1] 邓文娟[1] 康巍[1] 苏丹柯[1] ZHAO Yang;WANG Chen;DENG Wenjuan;KANG Wei;SU Danke(Medical Imaging Center,Guangxi Medical University Cancer Hospital,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院医学影像中心,广西南宁530021

出　　处：《实用放射学杂志》2022年第2期232-235,244,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81760517);广西影像医学临床医学研究中心建设项目(桂科AD20238096).

摘　　要：目的探讨乳腺浸润性导管癌新辅助化疗(NAC)前后,癌灶液实性区表观扩散系数(ADC)与K-i 67表达水平动态改变的相关性,探讨其预后评估价值.方法回顾性分析30例含液性区的乳腺浸润性导管癌患者NAC前后数据:液性区ADC值(ADC液性区)、实性区ADC值(ADC实性区)、液实性区ADC值(ADC比值)及NAC前、手术后K-i 67表达水平,采用配对t检验对NAC前后各ADC值、K-i 67指数进行差异性分析.依据NAC前后K-i 67指数变化趋势进行分组,即K-i 67降低组及未降低组,以Spearman相关系数法分析2组NAC前后各ADC值差值(ΔADC液性区、ΔADC实性区以及ΔADC比值)与K-i 67差值(ΔKi-67)的相关性.结果NAC后癌灶ADC实性区较前升高(P<0.001),而ADC液性区、ADC比值、K-i 67指数均较前降低(P<0.001,P<0.001,P=0.002).在K-i 67降低组中,仅ΔADC实性区与ΔKi-67呈中度负相关(r=-0.470,P=0.042),而ΔADC液性区、ΔADC比值与ΔKi-67均无相关性(P>0.05).在K-i 67未降低组中,ΔADC液性区、ΔADC实性区、ΔADC比值与ΔKi-67均无相关性(P>0.05).结论乳腺浸润性导管癌NAC前后ADC液性区、ADC实性区以及ADC比值中,仅部分病例ΔADC实性区与ΔKi-67有相关性,ΔADC实性区具有一定的预后评估价值.Objective To investigate the correlation between apparent diffusion coefficient(ADC)values and K-i 67 index during neoadj uvant chemotherapy(NAC)in breast invasive ductal carcinomas fluid solid area,and to evaluate their prognostic values.Methods The ADC value of the fluid area(ADCfluid area),solid area(ADCsolid area),the ratio of ADC(ADCratio)and the Ki-67 index before and after NAC in 30 cases were analyzed retrospectively.Paired-t test was used to compare the differences of the ADC values and the K-i 67 index during NAC.Patients were divided into the K-i 67 decreased group and the none decreased group according to the change trend of the K-i 67 index.Spearman was used to analyze the correlation between the differences of the ADC values(ΔADCfluid area,ΔADCsolid area andΔADCratio)and the difference of the Ki-67 values(ΔKi-67)before and after NAC in the two groups.Results After NAC,the ADCsolid area was higher(P<0.001),while the ADCfluid area,ADCratio and Ki-67 index were lower(P<0.001,P<0.001,P=0.002).In the K-i 67 decreased group,theΔADCsolid area was negatively correlated with theΔKi-67(r=-0.470,P=0.042),while there were no correlations between theΔADCfluid area,ΔADCratio and theΔKi-67(P>0.05).In the Ki-67 none decreased group,there were no correlations between anyΔADC values and theΔK-i 67(P>0.05).Conclusion OnlyΔADCsolid area in three ADC values is correlated withΔKi-67,which demonstrated thatΔADCsolid area has potential prognostic value in breast invasive ductal carcinoma underwent NAC.

关 键 词：乳腺癌 新辅助化疗 表观扩散系数 液实性区 KI-67 

分 类 号：R737.9[医药卫生—肿瘤] R818.051[医药卫生—临床医学]