超声造影预测非小细胞肺癌颈部转移性淋巴结Ki-67表达水平的临床价值  

Clinical value of contrast-enhanced ultrasound in predicting Ki-67 expression level in cervical metastatic lymph nodes of non-small cell lung cancer

作　　者：韦力[1] 周军[1] 周畅[1] 刘蓉[1] 许涛 WEI Li;ZHOU Jun;ZHOU Chang;LIU Rong;XU Tao(Department of Ultrasound,Yichang Central People’s Hospital,Hubei 443000,China)

机构地区：[1]湖北省宜昌市中心人民医院超声科,443000

出　　处：《临床超声医学杂志》2023年第11期910-915,共6页Journal of Clinical Ultrasound in Medicine

摘　　要：目的 探讨超声造影(CEUS)预测非小细胞肺癌(NSCLC)颈部转移性淋巴结Ki-67表达水平的临床价值。方法 选取我院经超声引导下淋巴结穿刺活检确诊的NSCLC颈部转移性淋巴结患者52例,共计60枚颈部转移性淋巴结,根据淋巴结Ki-67表达水平分为Ki-67高表达组(Ki-67表达水平≥30%)42枚和Ki-67低表达组(Ki-67表达水平<30%)18枚,比较两组淋巴结常规超声特征、CEUS定性特征(灌注模式和灌注类型),以及整体、中央区及周边区CEUS定量参数。应用多因素Logistic回归分析筛选Ki-67表达水平的独立预测因子;分析各独立预测因子与Ki-67表达水平的相关性。绘制受试者工作特征(ROC)曲线分析CEUS预测Ki-67表达水平的诊断效能。结果 两组淋巴结常规超声特征和CEUS定性特征比较差异均无统计学意义。Ki-67高表达组淋巴结整体及中央区峰值强度(PI)、灌注速度(C)和周边区PI均大于Ki-67低表达组,中央区曲线下面积(AUC)高于低表达组,差异均有统计学意义(均P<0.05);两组其余CEUS定量参数比较差异均无统计学意义。多因素Logistic回归分析显示,中央区AUC、C均为Ki-67表达水平的独立预测因子(均P<0.05)。相关性分析显示,中央区AUC、C与Ki-67表达水平均呈正相关(r=0.543、0.552,均P<0.001)。ROC曲线分析显示,中央区AUC、C预测Ki-67表达水平的曲线下面积分别为0.844、0.901。结论 CEUS定量参数颈部转移性淋巴结中央区AUC、C可以预测Ki-67表达水平,有助于临床无创评价NSCLC的肿瘤生物学特性。Objective To explore the clinical value of contrast-enhanced ultrasound(CEUS)in predicting Ki-67 expression level in cervical metastatic lymph nodes of non-small cell lung cancer(NSCLC).Methods Fifty-two patients with cervical lymph node metastasis of NSCLC diagnosed by ultrasound-guided lymph node biopsy in our hospital were selected,totally 60 cervical metastatic lymph nodes.The patients were divided into high-expression group(Ki-67 expression level≥30%,42 nodes)and low-expression group(Ki-67 expression level<30%,18 nodes)according to the Ki-67 expression level in lymph nodes.The conventional ultrasound features and CEUS qualitative characteristics(perfusion mode and perfusion type),and overall,central,and peripheral CEUS quantitative parameters between the two groups were compared.Multiple Logistic regression analysis was used to screened independent predictors of Ki-67 expression level,and the correlation between each predictor and Ki-67 expression level was analyzed.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of CEUS quantitative parameters in predicting Ki-67 expression level.Results There were no statistically significant differences in conventional ultrasound features and CEUS qualitative features between the two groups.In the high expression group,the peak intensity(PI),perfusion velocity(C),and peripheral PI of overall and central lymph node areas were higher than those in the low-expression group,and the central area under the curve(AUC)was higher than that in the low expression group,with the differences were statistically significant(all P<0.05).There were no statistically significant differences in other CEUS quantitative parameters between the two groups.Multiple Logistic regression analysis showed that central AUC and C were independent predictors of Ki-67 expression level(both P<0.05).Correlation analysis showed that the central AUC and C were positively correlated with Ki-67 expression level(r=0.543,0.552,both P<0.001).The area under the ROC curve f

关 键 词：超声检查 造影剂 非小细胞肺癌 颈部转移性淋巴结 Ki-67表达水平 

分 类 号：R445.1[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]