直肠癌术前ADC值与肿瘤分化程度及Ki-67增殖指数的相关性

Association of preoperative ADC value of DW-MRI with tumor differentiation and Ki-67 expression in patients with rectal cancer

目的探讨直肠癌磁共振扩散加权成像(DW-MRI)表观扩散系数(ADC)值与肿瘤分化程度及Ki-67增殖指数的相关性。方法选取经手术病理学检查证实为直肠癌的125例患者,术前1周内均行DW-MRI检查并测得ADC值,术后标本肿瘤实质部分进行组织病理学检查;比较不同肿瘤分化程度直肠癌术前ADC值的差异,同时计算Ki-67增殖指数,分析其与ADC值的相关性。结果直肠癌术前ADC值为(0.83±0.16)×10^(-3)mm^2/s。术后组织病理学检查结果显示高分化29例,中分化71例,低分化25例,不同肿瘤分化程度直肠癌术前ADC值比较,差异有统计学意义(P<0.05)。Ki-67增殖指数为(55.3±20.2)%,与直肠癌术前ADC值呈负相关(r=-0.19,P<0.05)。结论直肠癌术前ADC值能反映肿瘤分化程度及Ki-67增殖指数的高低;ADC值越低,肿瘤侵袭性越强。

Objective To investigate the association of apparent diffusion coefficient(ADC) of MR diffusion weighted imaging(DW-MRI) with tumor differentiation and Ki67 expression in patients with rectal cancer. Methods Clinical data of 125 patients with rectal cancer were retrospectively analyzed. All patients underwent MRI scan one week prior to the operations and the mean ADC value was measured. The histopathological examination with HE staining was performed and the expression of Ki-67 in tumor tissue was detected with immunohistochemistry. The association of preoperative ADC values with tumor differentiation and the expression of Ki-67 was analyzed. Results The mean preoperative ADC values of rectal cancer was (0.83±0.16)×10^-3mm^2/s. Histopathological examinations showed that the well differentiated, median differentiated and low differentiated cases were 29, 71 and 25 respectively. Preoperative ADC values were significantly associated with tumor differentiation (P<0.05).The mean Ki-67 proliferation index was (55.3±20.2)%. Ki-67 was negatively correlated with preoperative ADC value of rectal cancer (r=-0.19, P<0.05). Conclusion Preoperative ADC value may reflect the degree of tumor differentiation and Ki-67 proliferation index in patients with rectal cancer. The tumor with lower ADC values would be more aggressive.