DWI、DCE-MRI参数值对Ⅰ型与Ⅱ型子宫内膜癌的鉴别诊断及与Ki-67、P53的关系

Differential Diagnostic Value of DWI and DCE-MRI Parameters for TypeⅠand typeⅡEndometrial Carcinoma and Its Relationship with Ki-67 and P53

目的 探讨DWI、DCE-MRI参数值对Ⅰ、Ⅱ型子宫内膜癌(EC)的鉴别诊断价值;并分析各参数与Ki-67、P53的关系。方法 方法回顾性分析2018年5月至2021年5月运城市中心医院收治并手术病理证实的72例EC的临床资料。所有患者于术前行盆腔DWI、DCE-MRI检查,测量实性病灶ADC值、K^(trans)值、K_(ep)值、V_(e)值,并进行比较,若差异有统计学意义绘制ROC曲线,并评估诊断效能。统计72例EC患者Ki-67、P53的表达情况,分析与ADC值、K^(trans)值、K_(ep)值、V_(e)值之间的关系。结果 Ⅱ型EC较Ⅰ型ADC值降低,K^(trans)值、K_(ep)值、V_(e)值升高,差异有统计学意义。ADC值、K^(trans)值、K_(ep)值、V_(e)值的AUC分别为0.735、0.674、0.891、0.739,截断值分别为0.835、0.500、0.715、0.695,特异性分别为95.20%、68.60%、70.60%、66.70%,敏感性分别为47.10%、61.90%、9 5.20%、81.00%。Ki-67高表达组较低表达组/P53阳性组较阴性组,ADC值降低,K^(trans)值、K_(ep)值、V_(e)值升高,差异有统计学意义(P<0.05)。结论 1.ADC值、K_(ep)值、V_(e)值对于术前诊断Ⅱ型EC有较高的准确性。2.ADC值,K^(trans)值、K_(ep)值、V_(e)值值与Ki-67、P53表达之间有关联,可以作为EC预后评估的参考指标。

Objective The role of parameter values of DWI and DCE-MRI in the differential diagnosis of typeⅠand typeⅡendometrial carcinoma(EC).The relationship between various parameters and Ki-67 and P53 was found.Methods The clinical data of 72 EC patients who were admitted to Yuncheng Central Hospital and confirmed by surgery and pathology from May 2018 to May 2021 were retrospectively analyzed.All patients underwent DWI and DCE-MRI examinations before operation.By measuring the ADC value,Ktrans value,Kep value,Ve value of the parenchymal part of the lesion and comparing and drawing the ROC curve,the diagnostic efficacy of each parameter was evaluated.The expressions of Ki-67,P53 in 72 patients with EC were counted,and the relationship between them and ADC value,Ktrans value,Kep value and Ve value was analyzed.Results Compared with typeⅠEC,typeⅡEC had lower ADC value and higher Ktrans value,Kep value and Ve value,with a statistically significant difference.The AUCs of ADC value,Ktrans value,Kep value,and Ve value were 0.735,0.674,0.891,and 0.739,respectively.The cutoff values are 0.835,0.500,0.715,0.695,respectively.The specificities were 95.20%,68.60%,70.60%,and 66.70%,respectively.The sensitivities were 47.10%,61.90%,95.20%,and 81.00%,respectively.The high expression group of Ki-67 had lower ADC value,higher Ktrans value,Kep value and Ve value;The P53 positive group had lower ADC values and higher Ktrans,Kep,and Ve values.(P<0.05).Conclusion 1.ADC value,Kep value and Ve value have high accuracy for preoperative diagnosis of typeⅡEC.2.ADC value,Ktrans value,Kep value and Ve value are correlated with the expression of Ki-67 and P53,which can be used as a reference index for the prognosis evaluation of EC.