卵巢上皮癌ADC值在分型中的价值及其与Ki67蛋白表达的相关性研究

The Correlative Study of Apparent Diffusion Coefficient Value and Ki67 Protein Expression in Epithelial Ovarian Cancer

目的探讨卵巢上皮癌弥散加权成像(DWI)参数ADC值在分型中的价值及其与Ki67的相关性。方法回顾性分析2017年1月至2022年7月经唐山市妇幼保健院病理证实为卵巢上皮癌的完整影像学资料共计113例,通过DWI序列获取ADC值;采用免疫组织化学法检测Ki67表达情况及其与ADC值的相关性。结果Ⅰ型与Ⅱ型卵巢上皮癌组平均ADC值、最小ADC值分别为:(1.09±0.21)×10^(-3)mm^(2)/s、(0.75±0.12)×10^(-3)mm^(2)/s和(0.88±0.20)×10^(-3)mm^(2)/s、(0.59±0.11)×10^(-3)mm^(2)/s,两组间比较均存在统计学差异(t=10.56、9.10;P<0.01);ROC曲线结果示:平均ADC值、最小ADC值鉴别Ⅰ、Ⅱ型卵巢上皮癌的曲线下面积(AUC)值为0.936、0.916;Ki67弱阳性组、阳性组与强阳性组平均ADC值、最小ADC值分别为:(1.13±0.23)×10^(-3)mm^(2)/s、(0.90±0.16)×10^(-3)mm^(2)/s、(0.70±0.12)×10^(-3)mm^(2)/s及(0.92±0.22)×10^(-3)mm^(2)/s、(0.70±0.14)×10^(-3)mm^(2)/s、(0.56±0.10)×10^(-3)mm^(2)/s,各组间比较差异也均存在统计学意义(F=57.05、43.38;P<0.01);平均ADC值、最小ADC值与Ki67均呈一定负相关(r=-0.63、-0.59;P<0.01)。结论平均ADC值、最小ADC值在卵巢上皮癌分型诊断中有较高价值,且与Ki67具有一定相关性,可无创评估卵巢上皮癌的生物学特性,成为术前预测肿瘤恶性程度的影像学参考指标。

Objective To evaluate the value of ADC value in the differentiation between epithelial ovarian cancer subtypes,and investigate the correlation between ADC value and Ki67 in diffusion weighted imaging(DWI)of epithelial ovarian cancer.Methods A total of 113 cases of ovarian epithelial cancer confirmed by pathology in Tangshan Maternal and Child Health Hospital from January 2017 to July 2022 were analyzed retrospectively,and ADC values were obtained by DWI sequence Immunohistochemistry was used to detect Ki67 expression and its correlation with ADC value.Results The average ADC value and minimum ADC value of typeⅠand typeⅡepithelial ovarian cancer were(1.09±0.21)×10^(-3)mm^(2)/s,(0.75±0.12)×10^(-3)mm^(2)/s and(0.88±0.20)×10^(-3)mm^(2)/s,(0.59±0.11)×10^(-3)mm^(2)/s respectively(t=10.56、9.10;P<0.01),with statistical differences between the two groups;ROC curve results showed that the area under the ROC curve(AUC)values of average ADC value and minimum ADC value for distinguishing typeⅠandⅡovarian epithelial carcinoma were 0.936 and 0.916;The average ADC value and minimum ADC value of Ki67 weak positive group,positive group and strong positive group were(1.13±0.23)×10^(-3)mm^(2)/s,(0.90±0.16)×10^(-3)mm^(2)/s,(0.70±0.12)×10^(-3)mm^(2)/s and(0.92±0.22)×10^(-3)mm^(2)/s、(0.70±0.14)×10^(-3)mm^(2)/s、(0.56±0.10)×10^(-3)mm^(2)/s respectively,the differences among the groups were also statistical significance(F=57.05,43.38;P<0.01);Average ADC value and minimum ADC value were negatively correlated with Ki67(r=-0.63,-0.59;P<0.01).Conclusion The average ADC value and the minimum ADC value have high value in categorizing ovarian epithelial cancer,and have a certain correlation with Ki67,which can be used to non-invasively evaluate the biological characteristics of ovarian epithelial cancer,making it a possible imaging index to predict the malignant degree of tumor before operation.