BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly malignant and aggressive tumor,and high Ki-67 expression indicates poor histological differentiation and prognosis.Therefore,one of the challenges in diagno...BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly malignant and aggressive tumor,and high Ki-67 expression indicates poor histological differentiation and prognosis.Therefore,one of the challenges in diagnosing preoperatively patients with PDAC is predicting the degree of malignancy.Dynamic contrast-enhanced ultrasonography(DCE-US)plays a crucial role in abdominal tumor diagnosis,and can adequately show the microvascular composition within the tumors.However,the relationship between DCE-US and the Ki-67 labelling index remains unclear at the present time.AIM To predict the correlation between Ki-67 expression and the parameters of DCEUS.METHODS Patients with PDAC who underwent DCE-US were retrospectively analyzed.Patients who had received any treatment(radiotherapy or chemotherapy)prior to DCE-US;had incomplete clinical,imaging,or pathologic information;and had poor-quality image analysis were excluded.Correlations between Ki-67 expression and the parameters of DCE-US in patients with PDAC were assessed using Spearman’s rank correlation analysis.The diagnostic performances of these parameters in high Ki-67 expression group were evaluated according to receiver operating characteristic curve.RESULTS Based on the Ki-67 labelling index,30 patients were divided into two groups,i.e.,the high expression group and the low expression group.Among the relative quantitative parameters between the two groups,relative half-decrease time(rHDT),relative peak enhancement,relative wash-in perfusion index and relative wash-in rate were significantly different between two groups(P=0.018,P=0.025,P=0.028,P=0.035,respectively).The DCE-US parameter rHDT was moderately correlated with Ki-67 expression,and rHDT≥1.07 was more helpful in accurately diagnosing high Ki-67 expression,exhibiting a sensitivity and specificity of 53.8%and 94.1%,respectively.CONCLUSION One parameter of DCE-US,rHDT,correlates with high Ki-67 expression.It demonstrates that parameters obtained noninvasively by DCE-US could better predict Ki-67 expression in PDAC preoperatively.展开更多
目的探讨多模态磁共振成像技术及其定量和定性参数预测胶质瘤Ki-67表达水平的价值。材料与方法选取330例胶质瘤患者,其中异柠檬酸脱氢酶(isocitrate dehydrogenase,IDH)野生型201例,IDH突变型129例。获得常规MRI特征、表观扩散系数(appa...目的探讨多模态磁共振成像技术及其定量和定性参数预测胶质瘤Ki-67表达水平的价值。材料与方法选取330例胶质瘤患者,其中异柠檬酸脱氢酶(isocitrate dehydrogenase,IDH)野生型201例,IDH突变型129例。获得常规MRI特征、表观扩散系数(apparentdiffusion coefficient,ADC)、动态对比增强(dynamic contrast-enhanced,DCE)MRI定性及定量参数时间-强度曲线(time-intensity curve,TIC)、转运常数(volume transfer constant,K^(trans))、渗出速率常数(the rate constant,K_(ep))、血管外细胞外容积分数(fractional volume of the extravascular-extracellular,V_(e))、血浆分数(plasma fraction,V_(p))及磁共振波谱(magnetic resonance spectroscopy,MRS)代谢产物比值,对胶质瘤患者进行logistic回归,以确定与Ki-67表达水平相关因素。用受试者工作特征曲线下面积(area under the curve,AUC)评价预测模型的性能。结果在胶质瘤患者分析中,K^(trans)(OR=1.012,P<0.001)、ADC(OR=0.998,P<0.05)、强化程度(OR=3.317,P<0.05)是Ki-67表达水平的独立预测因素,AUC为0.893。结论K^(trans)、ADC和强化程度可能是预测胶质瘤Ki-67表达水平的有效参数。展开更多
文摘BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly malignant and aggressive tumor,and high Ki-67 expression indicates poor histological differentiation and prognosis.Therefore,one of the challenges in diagnosing preoperatively patients with PDAC is predicting the degree of malignancy.Dynamic contrast-enhanced ultrasonography(DCE-US)plays a crucial role in abdominal tumor diagnosis,and can adequately show the microvascular composition within the tumors.However,the relationship between DCE-US and the Ki-67 labelling index remains unclear at the present time.AIM To predict the correlation between Ki-67 expression and the parameters of DCEUS.METHODS Patients with PDAC who underwent DCE-US were retrospectively analyzed.Patients who had received any treatment(radiotherapy or chemotherapy)prior to DCE-US;had incomplete clinical,imaging,or pathologic information;and had poor-quality image analysis were excluded.Correlations between Ki-67 expression and the parameters of DCE-US in patients with PDAC were assessed using Spearman’s rank correlation analysis.The diagnostic performances of these parameters in high Ki-67 expression group were evaluated according to receiver operating characteristic curve.RESULTS Based on the Ki-67 labelling index,30 patients were divided into two groups,i.e.,the high expression group and the low expression group.Among the relative quantitative parameters between the two groups,relative half-decrease time(rHDT),relative peak enhancement,relative wash-in perfusion index and relative wash-in rate were significantly different between two groups(P=0.018,P=0.025,P=0.028,P=0.035,respectively).The DCE-US parameter rHDT was moderately correlated with Ki-67 expression,and rHDT≥1.07 was more helpful in accurately diagnosing high Ki-67 expression,exhibiting a sensitivity and specificity of 53.8%and 94.1%,respectively.CONCLUSION One parameter of DCE-US,rHDT,correlates with high Ki-67 expression.It demonstrates that parameters obtained noninvasively by DCE-US could better predict Ki-67 expression in PDAC preoperatively.
文摘目的探讨表观扩散系数(apparent diffusion coefficient,ADC)鉴别诊断肺癌脑转移瘤组织学分型的价值及其与Ki-67增殖指数之间的关系。材料与方法回顾性分析经手术病理证实的20例小细胞肺癌脑转移瘤和41例非小细胞肺癌脑转移瘤患者的资料,并测定其Ki-67增殖指数。在ADC图上测量肿瘤实性部分的最小ADC值(the minimum ADC,ADCmin)、平均ADC值(the mean ADC,ADCmean)及对侧正常脑白质ADC值,并计算相对ADCmin(relative ADCmin,rADCmin)及相对ADCmean(relative ADCmean,rADCmean)。对比分析二者ADC值的差异,绘制受试者工作特征(receiver operating characteristic,ROC)曲线评价ADC值的鉴别诊断价值,并计算ADC值与Ki-67增殖指数之间的相关性。结果小细胞肺癌脑转移瘤组的ADCmin、ADCmean、rADCmin及rADCmean值均小于非小细胞肺癌脑转移瘤组,组间差异均具有统计学意义(P<0.05)。各ADC值均能对小细胞肺癌脑转移瘤及非小细胞肺癌脑转移瘤进行有效鉴别,其中rADCmean值的鉴别诊断效能最好,曲线下面积(area under the curve,AUC)为0.950[95%置信区间(confidence interval,CI):0.907~0.994],最佳截断值为0.955,相应的敏感度和特异度分别为96.23%、83.87%,准确度为91.67%。小细胞肺癌脑转移瘤组的Ki-67增殖指数大于非小细胞肺癌脑转移瘤组,组间差异具有统计学意义(P<0.05)。61例肺癌脑转移瘤患者的ADCmin、ADCmean、rADCmin及rADCmean值均与Ki-67增殖指数呈不同程度的负相关(r=-0.506、r=-0.480、r=-0.569、r=-0.541)。结论ADC值可以对肺癌脑转移瘤的组织学分型进行鉴别诊断,并可以预测Ki-67增殖指数的表达水平。
文摘目的探讨多模态磁共振成像技术及其定量和定性参数预测胶质瘤Ki-67表达水平的价值。材料与方法选取330例胶质瘤患者,其中异柠檬酸脱氢酶(isocitrate dehydrogenase,IDH)野生型201例,IDH突变型129例。获得常规MRI特征、表观扩散系数(apparentdiffusion coefficient,ADC)、动态对比增强(dynamic contrast-enhanced,DCE)MRI定性及定量参数时间-强度曲线(time-intensity curve,TIC)、转运常数(volume transfer constant,K^(trans))、渗出速率常数(the rate constant,K_(ep))、血管外细胞外容积分数(fractional volume of the extravascular-extracellular,V_(e))、血浆分数(plasma fraction,V_(p))及磁共振波谱(magnetic resonance spectroscopy,MRS)代谢产物比值,对胶质瘤患者进行logistic回归,以确定与Ki-67表达水平相关因素。用受试者工作特征曲线下面积(area under the curve,AUC)评价预测模型的性能。结果在胶质瘤患者分析中,K^(trans)(OR=1.012,P<0.001)、ADC(OR=0.998,P<0.05)、强化程度(OR=3.317,P<0.05)是Ki-67表达水平的独立预测因素,AUC为0.893。结论K^(trans)、ADC和强化程度可能是预测胶质瘤Ki-67表达水平的有效参数。
