肌肉骨骼肿瘤磁共振表观扩散系数与Ki-67表达的相关性

Correlation of Apparent Diffusion Coefficient and Ki-67 in Musculoskeletal Neoplasms

目的探讨原发性肌肉骨骼系统肿瘤磁共振扩散加权成像(DWI)的表观扩散系数(ADC)值与肿瘤Ki-67表达的相关性,评价其在鉴别肿瘤良恶性及反映肿瘤生物学特性中的价值。资料与方法回顾性分析61例行DWI检查的原发性肌肉骨骼系统肿瘤患者,所有病例术后均检测Ki-67表达情况,分析肿瘤实质部位ADC值与肿瘤Ki-67表达的相关性。结果 61例患者中,良性肿瘤34例,ADC值为(1.58±0.82)×10-3 mm2/s;恶性肿瘤27例,ADC值为(1.28±0.32)×10-3 mm2/s,两者差异无统计学意义(t=1.34,P>0.05);9例富含黏液基质的肿瘤ADC值为(2.32±0.19)×10-3 mm2/s,52例其他肿瘤ADC值为(1.36±0.37)×10-3 mm2/s,两者差异有统计学意义(t=0.704,P<0.05)。良性肿瘤Ki-67标记指数为(9.24±7.17)%,恶性肿瘤Ki-67标记指数为(40.14±16.57)%,两者差异有统计学意义(t=-4.13,P<0.001)。良、恶性肿瘤ADC值与Ki-67标记指数呈负相关(r=-0.409,P<0.01)。结论良、恶性肌肉骨骼系统肿瘤ADC值与Ki-67表达呈负相关,但ADC值无法鉴别肿瘤的良恶性。当ADC值>2.0×10-3 mm2/s时对诊断富含黏液基质的肿瘤有一定的价值。

Purpose To investigate the correlation of apparent diffusion coefficient(ADC) measured by diffusion weighted imaging(DWI) and Ki-67 in musculoskeletal neoplasms, and to evaluate its value in differentiating benign and malignant disease. Materials and Methods Sixty-one cases of primary musculoskeletal neoplasms were retrospectively reviewed. The expression of Ki-67 was determined post-surgery to correlate with ADC of the solid tumor portion. Results There were 34 cases of benign tumors in 61 patients with ADC value of(1.58±0.82)×10-3 mm2/s. In 27 malignant tumors, the ADC value was(1.28±0.32)×10-3 mm2/s. There was no statistical significance(t=1.34, P>0.05). Nine tumors were rich in mucinous matrix with ADC value of(2.32±0.19)×10-3 mm2/s; the other 52 tumors showed ADC value of(1.36±0.37)×10-3 mm2/s. This was statistically significant(t=0.704, P<0.05). The Ki-67 expression index was(9.24±7.17)% for benign tumors and(40.14±16.57)% for malignant tumors with statistical significance(t=-4.13, P<0.001). The ADC values were negatively correlated with Ki-67 index(r =- 0.409, P<0.01). Conclusion The ADC value of benign and malignant tumors is negatively correlated with Ki-67 expression. However ADC value alone cannot differentiate benign and malignant tumors. When ADC value is >2.0×10-3 mm2/s, the tumor has high content of mucinous matrix.