头颈部非霍奇金淋巴瘤扩散加权成像ADC值与Ki-67表达相关性分析

Analysis of the correlation between ADC value of diffusion weighted imaging and Ki-67 expression in non-Hodgkin lymphoma of head and neck

目的 :探讨头颈部非霍奇金淋巴瘤(Non-Hodgkin’s lymphoma,NHL)的表观扩散系数(Apparent diffusion coefficient,ADC)值与预后因子Ki-67指数的相关性及其在评价NHL化疗疗效中的应用价值。方法 :收集2016年9月-2018年7月在我院行MRI检查并经病理确诊的头颈部NHL患者42例,分为NK-T细胞淋巴瘤(NK-T cell lymphoma,NKTCL)组及弥漫大B细胞淋巴瘤(Diffuse large B cell lymphoma,DLBCL)组、Ki-67低表达组和Ki-67高表达组、化疗后有变化组和无变化组。分别测量各组肿瘤的ADC值并分析与Ki-67表达水平的相关性。结果:病灶平均ADC值与Ki-67指数呈负相关(r=-0.779,P=0.000),Ki-67低表达组患者肿瘤的平均ADC值明显高于Ki-67高表达组(P=0.000);Ki-67低表达组及Ki-67高表达组ADC值与Ki-67指数呈明显负相关(P<0.05),DLBCL组及NKTCL组ADC值与Ki-67指数呈明显负相关(P<0.05);有变化组化疗前后ADC值变化具有统计学意义(P<0.05),无变化组与有变化组ADC值变化的差异有统计学意义(P<0.05)。结论:ADC值与头颈部NHL的Ki-67表达有关,Ki-67指数越高,ADC值越低,淋巴瘤化疗前、后ADC值变化有助于疗效监测。因此,DWI联合MR常规扫描能无创性评价头颈部NHL的生物学行为。

Objective: To investigate the correlation between apparent diffusion coefficient(ADC) and prognostic factor Ki-67 expression in non-Hodgkin’s lymphoma(NHL) of head and neck and the effect of ADC value in evaluating the efficacy of NHL chemotherapy. Methods: A total of 42 patients underwent MRI examination at our hospital and confirmed by pathology as NHL of head and neck from September 2016 to July 2018. They were divided into NK-T cell lymphoma(NKTCL) group and diffuse large B cell lymphoma(DLBCL) group, Ki-67 low expression group and Ki-67 high expression group, the changing group and the no changing group. The ADC value of each group was calculated and the correlation between the ADC value and the expression of Ki-67 was analyzed. Results: The average ADC value was negatively correlated with the Ki-67 index(r =-0.779, P =0.000). The average ADC value of low expression group was significantly higher than that of high expression group(P=0.000). The ADC values of Ki-67 low expression group and high expression group were negatively correlated with Ki-67 index(P<0.05). The ADC values of DLBCL group and NKTCL group were negatively correlated with Ki-67 index(P<0.05). The difference of the ADC value before and after chemotherapy in the changing group was significantly different(P <0.05). The difference of ADC value of the changing group was significantly different with the no changing group(P <0.05).Conclusion: The ADC value is related to the expression of Ki-67 in NHL of head and neck. The lower the ADC value is,the higher the Ki-67 index is in NHL. The changes of ADC value can monitor the effect of chemotherapy. Accordingly, DWI combined with MR routine scan can non-invasively evaluate the biological behavior in NHL of head and neck.