表观扩散系数术前区分Luminal型与非Luminal型乳腺癌及其与Ki-67增殖指数的相关性研究  

The value of apparent diffusion coefficient value in differentiating the Luminal-type and non-Luminal-type breast cancer and evaluating tumor cell proliferation activity

作　　者：刘宏[1] 刘显旺 刘光耀[1] 周洁 周俊林[1] LIU Hong;LIU Xianwang;LIU Guangyao;ZHOU Jie;ZHOU Junlin(Radiology Department of Lanzhou University Second Hospital,Second Clinical School of Lanzhou University,Key Laboratory of Medical Imaging of Gansu Province,Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院放射科,兰州大学第二临床医学院,甘肃省医学影像重点实验室,医学影像人工智能甘肃省国际科技合作基地,兰州730030

出　　处：《磁共振成像》2023年第4期51-56,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金项目(编号:82260361)。

摘　　要：目的 探讨表观扩散系数(apparent diffusion coefficient, ADC)术前区分Luminal型与非Luminal型乳腺癌的效能及其与Ki-67增殖指数之间的相关性。材料与方法 回顾性分析经病理证实为Luminal型乳腺癌88例和非Luminal型乳腺癌30例,并检测其Ki-67增殖指数。在ADC图上测量病灶实质的最小ADC值(the minimum ADC, ADCmin)、平均ADC值(the mean ADC, ADCmean)和相应对侧正常乳腺腺体组织的ADC值,计算相对ADCmin (relative ADCmin, rADCmin)和相对ADCmean(relative ADCmean, rADCmean)。比较Luminal型与非Luminal型乳腺癌组间ADC值差异,绘制受试者工作特征(receiver operating characteristic, ROC)曲线,分析ADC值对Luminal型与非Luminal型乳腺癌的鉴别效能及其与Ki-67增殖指数间的相关性。结果 Luminal型乳腺癌组的ADCmin、ADCmean、rADCmin和rADCmean值均低于非Luminal型乳腺癌组,组间差异具有统计学意义(P均<0.05)。ROC结果显示各ADC值均能对Luminal型与非Luminal型乳腺癌进行有效区分,其中,rADCmin鉴别效能最佳,最佳截止值为0.599,相应的曲线下面积(area under the curve, AUC)、敏感度、特异度分别为0.796 [95%(confidence interval, CI):0.712~0.864]、90.91%(95%CI:82.90%~96.00%)和63.33%(95%CI:43.90%~80.10%)。乳腺癌ADCmin、ADCmean、rADCmin和rADCmean与Ki-67增殖指数间均呈不同程度的负相关关系[r=-0.343(95%CI:-0.493~-0.173)、 r=-0.474 (95%CI:-0.603~-0.321)、 r=-0.325 (95%CI:-0.478~-0.154)、 r=-0.322 (95%CI:-0.475~-0.150),P均<0.05]。结论 ADC值可用于鉴别Luminal型与非Luminal型乳腺癌,可以在一定程度上评估肿瘤细胞增殖活性。Objective:To explore the efficacy of apparent diffusion coefficient(ADC)in distinguishing between Luminal and non-Luminal breast cancer and its correlation with Ki-67 proliferation index.Materials and Methods:Eighty-eight cases of Luminal breast cancers and 30 cases of non-Luminal breast cancers were confirmed pathologically,and their Ki-67 proliferation index was assessed through immunohistochemistry.The minimum ADC value(ADCmin),the mean ADC value(ADCmean),and the ADC value of the corresponding contralateral normal breast gland tissue were measured on the ADC map.Additionally,the relative minimum ADC value(rADCmin)and the relative mean ADC value(rADCmean)were calculated.The differences in ADC values between the luminal and non-luminal breast cancer groups were compared,and the receiver operating characteristic(ROC)curves were drawn.Then,the differential efficacy of ADC values on luminal and non-luminal breast cancer and the correlation between ADC values and Ki-67 proliferation index were analyzed.Results:The ADCmin,ADCmean,rADCmin,and rADCmean values of the Luminal breast cancer group were lower than those in the non-Luminal breast cancer group,and the differences were statistically significant(P<0.05).The ROC results showed that each ADC value could effectively distinguish between Luminal type and non-Luminal type of breast cancer.Among them,rADCmin had the best discriminatory efficiency.The optimal cut-off value was 0.599,and the corresponding area under the curve(AUC),sensitivity,and specificity were 0.796[95%(confidence interval,CI):0.712-0.864],90.91%(95%CI:82.90%-96.00%),and 63.33%(95%CI:43.90%-80.10%),respectively.There were different degrees of negative correlation between ADCmin,ADCmean,rADCmin,and rADCmean,and Ki-67 proliferation index[r=-0.343(95%CI:-0.493--0.173),r=-0.474(95%CI:-0.603--0.321),r=-0.325(95%CI:-0.478--0.154),r=-0.322(95%CI:-0.475--0.150),all with P<0.05].Conclusions:The ADC values can be used to distinguish between Luminal type and non-Luminal type breast cancer,and they can also have

关 键 词：乳腺癌 Luminal型 磁共振成像 表观扩散系数 Ki-67增殖指数 鉴别 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]