卵巢癌MRI表现与Ki-67表达及预后的关系

Relationship between MRI Features,Ki-67 Expression and Prognosis of Ovarian Carcinoma

目的探索卵巢癌MRI表现与Ki-67表达水平及患者生存时间的关系。方法收集2013-2020年在南通市肿瘤医院住院的60例卵巢癌患者病例。术前行MRI检查,术后使用免疫组化方法检测肿瘤标本中Ki-67表达水平。以Ki-67≥50%为高表达、0-49%为低表达,分析不同卵巢癌Ki-67表达水平患者的临床病理、MRI特征的关系。随访卵巢癌患者术后生存状况,记录生存期并进行分析。结果不同TNM分期、分化程度的肿瘤,Ki-67表达差异有统计学意义(χ^(2)=4.029,P=0.0447;χ^(2)=5.4751,P=0.0193);而不同年龄、病理类型的肿瘤之间,Ki-67表达差异无统计学意义(P>0.05)。肿瘤不同MRI结构与Ki-67表达差异有统计学意义(χ^(2)=4.9138;P=0.0266);表现出“腹膜增厚强化”肿瘤与未表现出的相比,Ki-67差异有统计学意义(χ^(2)=4.444,P=0.035);而不同肿瘤直径、是否表现出“盆腔长T1长T2液性信号”、“后腹膜淋巴结肿大”的肿瘤之间,Ki-67表达差异均无统计学意义(P>0.05)。不同MRI结构患者之间,生存期差异具有统计学意义(χ^(2)=8.676,P=0.0131)。是否“腹膜增厚强化”两组患者间,生存期差异具有统计学意义(χ^(2)=5.996,P=0.0143)。结论部分MRI特征与Ki-67表达水平存在一定的关联,有望用于无创预估卵巢癌的预后。提示“肿瘤实性结构”、“腹膜增厚强化”者可能预后不良。

Objective To explore the relationship between MRI findings,Ki-67 expression and survival time of patients with ovarian cancer.Method Sixty cases of ovarian cancer hospitalized in Nantong tumor hospital from 2013 to 2020 were collected.MRI examination was performed before operation,and Ki-67 protein expression in tumor samples was detected by immunohistochemistry after operation.Sixty cases of ovarian cancer confirmed by pathology were collected.Based on the standard of Ki-67≥50%as high expression and 0~49%as low expression,the relationship between the different Ki-67 expression levels in ovarian cancer tissue samples and clinic-pathology and MRI features was analyzed.The postoperative survival of the patients was followed up,and the survival time was recorded and analyzed.Results The expression of Ki-67 in tumors in different TNM stages and differentiation was statistically significant,withχ^(2)=4.029,P=0.0447 andχ^(2)=5.4751,P=0.0193 respectively.There was no significant difference in the expression of Ki-67 between tumors of different ages and pathological types with both P>0.05.The expression of Ki-67 was significantly different in different structures of MRI tumors withχ^(2)=4.9138,P=0.0266.The expression of Ki-67 in tumors with"peritoneal thickening and enhancement"was statistically significant compared with those without"peritoneal thickening and enhancement",withχ^(2)=4.444,P=0.035.There was no significant difference in the expression of Ki-67 between tumors with different tumor diameters and whether they showed"pelvic long T1 long T2 liquid signal"and"retroperitoneal lymph node enlargement"with both P>0.05.The difference of survival time between patients with different structures on MRI was statistically significant withχ^(2)=8.676,and P=0.0131.The difference in the survival times of the patients with"peritoneal thickening and enhancement"between the two groups was statistically significant withχ^(2)=5.996,and P=0.0143.Conclusion Some MRI features of ovarian carcinoma are related to the Ki-67 expression,which could be used as a prognostic predictor noninvasively.The prognosis of patients with"solid structure of tumor"or"peritoneal thickening and enhancement"maybe poor.