磨玻璃影型浸润性肺腺癌实性成分占比及CT值与Ki-67表达的相关性及预测价值分析

Correlation of CTR and CT Value of GGO Type Invasive Pulmonary Adenocarcinoma with Ki-67 Level

目的:探讨磨玻璃影(GGO)型浸润性肺腺癌实性成分占比、CT值与Ki-67表达水平的相关性及预测价值。方法:回顾性分析101例GGO型浸润性肺腺癌的CT图像和Ki-67免疫组化结果,对Ki-67高、低增殖指数组间CT特征进行对比研究,并分析实性成分占比及CT值与Ki-67增殖指数相关性及预测价值。结果:分叶征及毛刺征在Ki-67高增殖指数组均多于低增殖指数组(P<0.05);肿瘤大小、空泡征、血管集束征及胸膜牵拉征组间差异无统计学意义(P>0.05)。实性成分占比及CT值于高增殖指数组均高于低增殖指数组(P<0.05)。实性成分占比、CT值与Ki-67增殖指数呈正相关,r值分别为0.617、0.590(P<0.001)。受试者操作特征曲线分析结果显示,实性成分占比、CT值及联合检测预测Ki-67增殖指数的AUC分别为0.791、0.750、0.796。结论:GGO型浸润性肺腺癌的实性成分占比和CT值均可一定程度预测Ki-67表达水平,实性成分占比的相关性及诊断效能优于CT值,可为术前预测肿瘤增殖活性提供新思路。

Objective:To investigate the correlation and predictive value between consolidation tumor ratio(CTR)and CT value with Ki-67 expression level of GGO invasive lung adenocarcinoma.Methods:The CT images and Ki-67 immunohistochemical results of 101 GGO type invasive lung adenocarcinoma were analyzed,to compare the CT characteristics between Ki-67 high and low proliferation index,and to analyze the CTR and CT value with Ki-67 proliferation index and predictive value.Results:The leaf and burr signs were more than Ki-67 high proliferation index(P<0.05),tumor size,vacuolation,vessel collection and pleural pull(P>0.05).The CTR and CT value were higher in the high proliferation index group than the low proliferation index group(P<0.05).The CTR and CT value were positively correlated with the Ki-67 proliferation index,with r values of 0.617 and 0.590,respectively(P<0.001).The ROC curve analysis showed that the AUC of CTR,CT value and the combined test for prediction of Ki-67 proliferation index were 0.791,0.750 and 0.796,respectively.Conclusion:The CTR and CT value of GGO invasive lung adenocarcinoma can predict the expression level of Ki-67 to some extent,and the correlation and diagnostic efficacy of the CTR are better than CT value,which can provide a new idea for predicting tumor proliferation activity before surgery.