肝细胞癌表观扩散系数与Ki-67表达水平的关系

Correlation Between Diffusion-Weighted Imaging of Hepatocellular Carcinoma and Proliferation Antigen Ki-67

目的分析肝细胞癌表观扩散系数(ADC)值与Ki-67表达水平的关系,探讨ADC值对鉴别Ki-67表达水平的效能。资料与方法43例经病理检查诊断为肝癌患者均行扩散加权成像(DWI)检查,b值分别取0、800 s/mm^(2),测量肝细胞癌病灶的平均ADC值。采用免疫组化染色检测Ki-67水平,并计算阳性表达细胞数。将Ki-67<20%纳入低表达组,Ki-67≥20%纳入高表达组。比较不同Ki-67表达水平患者的ADC值,使用受试者工作特征(ROC)曲线评价ADC值对Ki-67表达的鉴别效能。结果43例肝细胞癌患者中,DWI表现为高信号37例(86.0%),稍高信号4例(9.3%),等信号2例(4.7%)。高表达组患者ADC值低于低表达组,差异有统计学意义[(0.830±0.258)mm^(2)/s比(0.970±0.143)mm^(2)/s,P=0.034]。ROC曲线分析结果显示ADC值对Ki-67不同表达水平具有较好的鉴别效能,曲线下面积为0.681,敏感度为68.2%,特异度为71.4%。结论肝细胞癌的ADC值与Ki-67表达水平存在一定的关联。DWI有望用于无创预估肝细胞癌细胞增殖程度,为临床制订合理的治疗决策提供参考。

Purpose To analyze the correlation between apparent diffusion coefficient(ADC)value and Ki-67 expression,and to explore the efficacy of ADC value in distinguishing the expression level of Ki-67 in patients with hepatocellular carcinoma.Materials and Methods Diffusion weighted imaging(DWI)examinations were performed for all 43 patients with hepatocellular carcinoma(b value was 0 and 800 s/mm^(2),respectively),and the mean ADC value of hepatocellular carcinoma lesions were measured.Ki-67 was detected by immunohistochemical staining and the number of positive cells were calculated.All subjects were divided into two groups:low expression(patients with Ki-67<20%)group and high expression(patients with Ki-67≥20%)group.The differences of ADC value were compared between high and low expression groups.Receiver operating characteristic(ROC)curve was performed to evaluate the differential diagnostic efficiency of ADC value for Ki-67 expression.Results For 43 patients with hepatocellular carcinoma,there were 37 cases(86.0%)with obvious DWI hyperintensity,4 cases(9.3%)with slight DWI hyperintensity,and 2 cases(4.7%)with DWI isointensity.The ADC value of high expression group exhibited significantly decreases compared with those of the low expression group[(0.830±0.258)mm^(2)/s vs.(0.970±0.143)mm^(2)/s,P=0.034].The results of ROC analysis showed that the ADC value had a relatively good differential diagnostic efficiency for Ki-67 expression levels,with AUC of 0.681,sensitivity of 68.2%and specificity of 71.4%,respectively.Conclusion The ADC value has some associations with the Ki-67 expression in patients with hepatocellular carcinoma.DWI is expected to be used as a method for predicting the proliferation degree of hepatocellular carcinoma and providing some insights for clinical decision-making.