DKI直方图参数与肺癌Ki-67、TTF-1表达的相关性研究

Correlation of DKI Histogram Parameters with the Expression Level of Ki-67 and TTF-1 in Lung Cancer

目的 探讨扩散峰度成像(DKI)直方图参数与肺癌Ki-67、TTF-1表达的相关性。方法 前瞻性搜集经病理证实的肺癌患者61例,所有患者均于术前1周内行MRI检查,分析DWI和DKI图像,通过后处理分别得到表观扩散系数(ADC)、平均扩散峰度(MK)、平均扩散系数(MD)值的直方图参数,同时记录免疫组织化学标记物Ki-67、TTF-1表达情况。评估各直方图参数与Ki-67、TTF-1表达相关性,进一步采用受试者工作特征(ROC)曲线确定各参数预测Ki-67和TTF-1表达的诊断效能。结果 MD值10th percentile、ADC值10th percentile、kurtosis与TTF-1表达水平呈低度负相关(r=-0.334~-0.372,均P<0.05);MD值IQR、ADC值90th percentile、IQR与TTF-1表达水平呈低-中度正相关(r=0.250~0.430,均P<0.05),其中诊断效能最高的是MD值IQR,ROC曲线下面积为0.774,敏感度为45.45%,特异度为100%。MD值90th percentile、max、IQR、skewness与Ki-67表达呈低度负相关(r=-0.260~-0.325,均P<0.05),诊断效能最高的是max, ROC曲线下面积为0.700,敏感度为51.22%,特异度为95%。结论 DKI直方图部分参数与肺癌Ki-67、TTF-1表达具有不同程度相关性,可用于预测其表达。

Objective To investigate the correlation between diffusion kurtosis imaging(DKI)histogram parameters and Ki-67 and TTF-1 expression in lung cancer.Methods 61 lung cancer patients confirmed by pathology were prospectively collected.All patients underwent MRI examination within one week before surgery,andDWI and DKI images were analyzed.Histogram parameters of apparent diffusion coefficient(ADC),mean kurtosis(MK)and mean diffusivity(MD)were obtained by post-processing,and the expression results of immunohistochemical markers Ki-67 and TTF-1 were recorded.The correlation between each histogram parameter and Ki-67 and TTF-1 expression was assessed,and the diagnostic efficacy of each parameter in predicting Ki-67 and TTF-1 expression was further determined by receiver operating characteristic curve(ROC).Results MD value 10th percentile,ADC value 10th percentile,kurtosis were negatively correlated with TTF-1 expression(r=-0.334-0.372,P<0.05).MD value IQR,ADC value 90th percentile,IQR were positively correlated with TTF-1 expression level(r=0.250-0.430,P<0.05),and the MD value IQR had the highest diagnostic efficiency,and the area under the curve(AUC)was 0.774.The sensitivity was 45.45%and the specificity was 100%.MD value 90th percentile,max,IQR and skewness were negatively correlated with Ki-67 expression(r=-0.260-0.325,P<0.05),with the highest diagnostic efficacy being max with an ROC curve showing an area under the curve(AUC)of 0.700,sensitivity of 51.22%and specificity of 95%.Conclusion Some parameters of DKI histogram are correlated with the expression of Ki-67 and TTF-1 in lung cancer,which can be used to predict their expression.