DCE-MRI定量参数评估直肠癌分化程度及Ki67表达的应用价值研究  

Application Value of DCE-MRI Quantitative Parameters in Evaluating the Degree of Differentiation and Ki67 Expression of Rectal Cancer

作　　者：李玉 张凤翔[2] 张芳[2] LI Yu;ZHANG Feng-xiang;ZHANG Fang(Baotou Medical College,Inner Mongolia 014000,China;Department of Imaging,Ordos Central Hospital,Inner Mongolia 017000,China)

机构地区：[1]包头医学院,内蒙古014000 [2]鄂尔多斯市中心医院影像科,内蒙古017000

出　　处：《影像技术》2022年第3期57-62,共6页Image Technology

摘　　要：目的:探究动态磁共振成像(DCE-MRI)定量参数用来评估直肠癌分化程度及Ki67表达的应用价值。方法:本研究为前瞻性研究,收集2020年10月-2021年12月间于鄂尔多斯市中心医院直肠癌患者行DCE-MRI扫描且术后病理及免疫组化资料完整的病例43例,通过DCE-MRI获取K^(trans)(容积转运常数)、K_(ep)(速率常数)、V_(e)(细胞外间隙分数)等定量参数。肿瘤标本进行HE染色检测肿瘤分化程度,免疫组化法检测Ki67表达程度。将DCE-MRI定量参数K^(trans)、K_(ep)、V_(e)值与直肠癌分化程度及Ki67表达进行统计学分析。结果:直肠癌高分化组、中分化组、低分化组组间比较为K^(trans)值存在统计学差异(P<0.05),Kep值和Ve值无统计学差异(P>0.05)。直肠癌高分化组K^(trans)值为0.378±0.261/min,中分化组K^(trans)值为0.742±0.627/min,低分化组K^(trans)值为1.143±0.336/min。其中,高分化组K^(trans)值明显低于中分化组及低分化组(P<0.05);而中分化组和低分化组间K^(trans)值无统计学差异(P>0.05)。Ki67低表达组和高表达组定量参数值统计分析为两组间K^(trans)、K_(ep)值存在统计学差异(P<0.05),两组间V_(e)值无统计学差异(P>0.05)。ROC曲线分析显示Ki67两组间诊断K^(trans)的临界值为0.675/min,灵敏度和特异度分别为73%、41%,K_(ep)的临界值为0.214/min,灵敏度和特异度分别为87%、53%。Ki67两组间诊断V_(e)值灵敏度及特异度均较低(46%、37%)。结论:DCE-MRI定量参数能在一定程度上无创地反映直肠癌分化程度和Ki67表达情况。Objective:To investigate the application value of dynamic magnetic resonance imaging(DCE-MRI)quantitative parameters used to assess the degree of differentiation and Ki67 expression in rectal cancer.Methods:In this prospective study,43 rectal cancer patients with complete postoperative pathology and immunohistochemistry data who underwent DCE-MRI scans at Ordos Central Hospital between October 2020 and December 2021 were collected,and quantitative parameters such as K^(trans)(volume transport constant),K_(ep)(rate constant)and V_(e)(extracellular gap fraction)were obtained by DCE-MRI.The tumor specimens were subjected to HE staining to detect the degree of tumor differentiation and immunohistochemical method to detect the degree of Ki67 expression.The quantitative parameters of DCE-MRI,K^(trans),K_(ep),and V_(e),were statistically analyzed about to with concerning the degree of differentiation and Ki67 expression in rectal cancer.Results:The comparison between the highly differentiated,moderately differentiated,and poorly differentiated rectal cancer groups was statistically different for K^(trans) values(P<0.05),and there was no statistical difference for K_(ep) and V_(e) values(P>0.05).The K^(trans) value in the highly differentiated group was 0.378±0.261/min,the K^(trans) value in the moderately differentiated group was 0.742±0.627/min,and the K^(trans) value in the poorly differentiated group was 1.143±0.336/min.The K^(trans) value in the highly differentiated group was significantly lower than that in the moderately differentiated and poorly differentiated groups(both P<0.05),while the K^(trans) values in the moderately differentiated and poorly differentiated groups were statistically different(P<0.05).The statistical analysis of the quantitative parameter values of Ki67 in the low and high expression groups showed that there was a statistical difference in K^(trans) and K_(ep) values between the two groups(P<0.05),and no statistical difference in V_(e) values between the two groups(P>0.05).ROC curve ana

关 键 词：动态增强磁共振 KI67 直肠癌 定量参数 

分 类 号：R445.2[医药卫生—影像医学与核医学]