IVIM及DCE-MRI与非小细胞肺癌免疫组化指标MVD、EGFR和Ki67相关性的研究

Non-small Cell Lung Cancer:Correlation between Parameters from IVIM, DCE-MRI and Immunohistochemistry Indices MVD, EGFR and Ki67

目的评价IVIM和DCE-MRI的参数与非小细胞肺癌(NSCLC)免疫组化指标MVD、EGFR和Ki67的相关性。方法选择2013年4月至2015年2月入住我院的26例经手术病理证实为非小细胞肺癌的患者,同时接受IVIM和3D DCE-VIBE序列检查,分别得到IVIM的水分子扩散效应相关参数ADCtotal、D值和灌注相关参数D*、f值,DCE-MRI的灌注参数K^(trans)、K_(ep)、V_e和IAUC_(60)。使用Spearman等级相关系数计算MRI各参数与免疫组化指标MVD、EGFR和Ki67之间的相关性。结果 26例NSCLC患者的MVD均值为(36.5±21.1),EGFR阳性率为54.3%,Ki67指标的阳性率为86.4%。DCE参数中的IAUC_(60)与MVD有中等度的相关性,r值为0.687,P=0.000<0.05;K^(trans)与MVD有弱相关,r值为0.444,P=0.005<0.05。DCE参数与EGFR和Ki67无显著相关性。IVIM参数与三种免疫组化指标均无显著相关性。结论 1)DCE-MRI可评价NSCLC微循环状态;2)尚不能通过IVIM和DCE-MRI术前扫描提示NSCLC相关的EGFR、Ki67免疫组化结果。

Objective To evaluate the correlation between IVIM and DCE-MRI parameters and immunohistochenmical indices MVD. EGFR and Ki67. Methods From April 2013 to February 2015, 26 patients （13 males, 13 females： mean age 58 years, range 32-74 years） with pathologically confirmed non-small cell hung cancer were recruited. All patients underwent MR imaging. Axial single-shot respiratory triggered IVIM and breath holding 3D DCE-VIBE sequences were performed. Parameters of IVIM included ADCtotal and D value which reflected water molecule diffusion, and perfusion-related parameters D＊ and f values. Perfusion parameters of DCE-MRI were K, Kep, Ve and IAUC60. Spearman rank correlation coefficient was used to calculate the relationship between parameters from IVIM and DCE-MRI and immunohistochenical indices of MVD. EGFR and Ki67. Results Mean MVI） of the 26 NSCLCs was （36.5 ± 21.1）, positive rate of EGFR was 54.3%. and the positive rate of Ki67 index was 86.4%. Moderate correlation was found between IAUC60 and MVD with r value of 0.87（P=0.000 〈0.05）, and weak correlation was found between K and MVD wtih r value of 0.444（P=0.005〈0.05）. No significant correlation between DCE parameters and EGFR or Ki67 was found. No significant correlation between IVIM parameters and all three immunohistochemical indices was found. Conclusion 1） DCE-MRI. as a non-invasive method, can be used to evaluate the microcirculation ofhmg cancer. 2） DCE-MRI and IVIM may not be applied to predict the results of EGFR, and Ki67 of NSCLC.