IVIM定量参数与乳腺癌Ki67表达的相关性研究及其诊断评估

Study on the relationship between IVIM quantitative parameters and Ki67 expression in breast cancer and its diagnostic evaluation

目的探讨体素内不相干运动成像(intravoxel incoherent motion,IVIM)定量参数与乳腺癌免疫组化Ki67增殖指数表达的相关性并评估其诊断效能。方法选取2020年10月~2021年2月期间因乳腺病变在山东中医药大学附属医院行术前乳腺MRI检查,经术后病理证实为乳腺癌的患者42例,共42枚病灶。定量参数的获取利用GE工作站后处理软件分别计算生成真性扩散系数(D)、假性扩散系数(D^(*))及灌注分数(f)值。结果与Ki67高表达组相比,Ki67低表达组有更高的D值,组间差异有统计学意义(P<0.05),同时D值与Ki67的表达呈负相关,相关系数为(r=-0.315,P=0.013)。而D^(*)值与f值在不同Ki67表达组间均无明显相关性(P>0.05),差异无统计学意义;各参数受试者工作特征曲线(receiver operating charaeteristic curve,ROC)下面积(area under curve,AUC)分别为0.692、0.583、0.562,其中D值的诊断效能最高,当D值取0.609×10^(-3)mm^(2)时,敏感度为71.4%,特异度为43.9%。结论在IVIM定量参数中仅D值与乳腺癌Ki67的表达具有相关性且具有较高的诊断效能。而D^(*)和f值虽然与Ki67的表达相关性不强,但仍可以在一定程度上反映肿瘤的增殖情况,进而为临床判定乳腺癌Ki67的表达提供参考依据。

Objective To investigate the correlation between the quantitative parameters of voxel incoherent motion imaging(IVIM)and the expression of Ki67 proliferation index in immunohistochemistry of breast cancer and to evaluate its diagnostic efficiency.Methods From October 2020 to February 2021,preoperative breast MRI examination was performed in the affiliated Hospital of Shandong University of traditional Chinese Medicine.42 patients with breast cancer were confirmed by postoperative pathology.The real diffusion coefficient(D),false diffusion coefficient(D^(*))and perfusion fraction(f)were calculated by the post-processing software of GE workstation.Results Compared with the group with high expression of Ki67,the group with low expression of Ki67 had a higher D value,and the difference between the two groups was statistically significant.At the same time,there was a negative correlation between D value and the expression of Ki67,and the correlation coefficient was 0.315(r=0.315).There was no significant correlation between D^(*) value and f value among different Ki67 expression groups,and the difference was not statistically significant.The area(area under curve,AUC)under the subject working characteristic curve(receiver operating charaeteristic curve,ROC)of each parameter was 0.692,0.583 and 0.562 respectively,and the diagnostic efficiency of D value was the highest.When D value was 0.609×10^(-3) mm^(2),the sensitivity was 71.4%and the specificity was 43.9%.Conclusion Among the quantitative parameters of IVIM,only D value is correlated with the expression of Ki67 in breast cancer and has high diagnostic efficiency.Although the correlation between D^(*) and f and the expression of Ki67 is not strong,they can still reflect the value of tumor to a certain extent,and then provide a reference basis for clinical determination of the expression of Ki67 in breast cancer.