增强T2*加权血管成像序列多参数定量测量与子宫内膜癌增殖抗原Ki-67表达的相关性

Correlation Between Multi-parameter Quantitative Measurement of Enhanced T2~*-weighted Angiography Sequence and the Expression of Proliferating Cell Nuclear Antigen Ki-67 of Endometrial Carcinoma

目的探讨增强T2*加权血管成像(ESWAN)序列多参数定量测量与子宫内膜癌增殖抗原Ki-67表达的相关性。资料与方法选取2013年1月-2018年2月大连医科大学附属第一医院收治的经手术病理确诊的24例子宫内膜癌患者,均行MRI检查(含ESWAN序列),且免疫组化分析指标含Ki-67。测量病灶的幅度值、相位值、R2*值、T2*值等。按照Ki-67表达指数,将患者分为高表达组(n=13)和低表达组(n=11)。比较Ki-67高表达组、低表达组各参数值的差异;评估具有鉴别价值的参数对Ki-67高表达组、低表达组的鉴别效能;分析各参数值与Ki-67表达指数的相关性。结果 Ki-67高表达组的相位值、T2*值小于低表达组,R2*值大于低表达组,差异均有统计学意义(均P<0.05);两组幅度值差异无统计学意义(P>0.05)。相位值、R2*值、T2*值对Ki-67高表达组诊断的受试者工作特性曲线下面积分别为0.804、0.895、0.811。幅度值与Ki-67表达指数无相关性;相位值、T2*值与Ki-67表达指数呈负相关(r=-0.409、-0.632,P<0.05),R2*值与Ki-67表达指数呈正相关(r=0.747,P<0.001)。结论 ESWAN序列的相位值、R2*值、T2*值与Ki-67表达呈正相关,可反映子宫内膜癌肿瘤细胞增殖程度,其中R2*值为最佳参数。

Purpose To explore the correlation between multi-parameter quantitative measurement of enhanced T2＊-weighted angiography （ESWAN） sequence and expression of proliferating cell nuclear antigen Ki-67 of endometrial carcinoma. Materials and Methods Image data of 24 patients underwent MRI examination （including ESWAN sequence） admitted to the First Affiliated Hospital of Dalian Medical University from January 2013 to February 2018, and that were pathologically diagnosed as endometrial carcinoma with Ki-67 identified through immunohistochemical analysis was retrospectively analyzed. The amplitude value, phase value, R2＊ value, T2＊ value and other parameter values of the lesions were measured. According to Ki-67 expression index, the subjects included in this group were divided into high expression group （n=13） and low expression group （n=11）. The differences of each parameter value in Ki-67 high and low expression groups were compared. The discriminating efficacy of parameters with discriminating values on Ki-67 high and low expression groups was evaluated. The correlation between each parameter value and Ki-67 expression index was analyzed. Results The phase value and T2＊ value of Ki-67 high expression group were lower than those of the low expression group, coupled with R2＊ value higher than that of the low expression group （P〈0.05）, the difference of which was statistically significant （P〈0.05）. The phase value, R2＊ value and T2＊ value for the high expression of Ki-67 were 0.804, 0.895 and 0.811, respectively. There was no correlation between amplitude value and Ki-67 expression index. Phase value and T2＊ value was negatively correlated with Ki-67 expression index （r=-0.409 and -0.632, P〈0.05）, with R2＊ value positively correlated with Ki-67 expression index （r=0.747, P〈0.001）. Conclusion The phase value, R2＊ value and T2＊ value of ESWAN sequence are positively correlated with the expression of Ki-67, which can reflect the proliferation of endometrial cancer cells, among which R2＊ value is reckoned to be the best parameter.