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
BACKGROUND Prostate cancer(PCa)is a widespread malignancy,predominantly affecting elderly males,and current methods for diagnosis and treatment of this disease continue to fall short.The marker Ki-67(MKI67)has been pr...BACKGROUND Prostate cancer(PCa)is a widespread malignancy,predominantly affecting elderly males,and current methods for diagnosis and treatment of this disease continue to fall short.The marker Ki-67(MKI67)has been previously demonstrated to correlate with the proliferation and metastasis of various cancer cells,including those of PCa.Hence,verifying the association between MKI67 and the diagnosis and prognosis of PCa,using bioinformatics databases and clinical data analysis,carries significant clinical implications.AIM To explore the diagnostic and prognostic efficacy of antigens identified by MKI67 expression in PCa.METHODS For cohort 1,the efficacy of MKI67 diagnosis was evaluated using data from The Cancer Genome Atlas(TCGA)and Genotype-Tissue Expression(GTEx)databases.For cohort 2,the diagnostic and prognostic power of MKI67 expression was further validated using data from 271 patients with clinical PCa.RESULTS In cohort 1,MKI67 expression was correlated with prostate-specific antigen(PSA),Gleason Score,T stage,and N stage.The receiver operating characteristic(ROC)curve showed a strong diagnostic ability,and the Kaplan-Meier method demonstrated that MKI67 expression was negatively associated with the progression-free interval(PFI).The time-ROC curve displayed a weak prognostic capability for MKI67 expression in PCa.In cohort 2,MKI67 expression was significantly related to the Gleason Score,T stage,and N stage;however,it was negatively associated with the PFI.The time-ROC curve revealed the stronger prognostic capability of MKI67 in patients with PCa.Multivariate COX regression analysis was performed to select risk factors,including PSA level,N stage,and MKI67 expression.A nomogram was established to predict the 3-year PFI.CONCLUSION MKI67 expression was positively associated with the Gleason Score,T stage,and N stage and showed a strong diagnostic and prognostic ability in PCa.展开更多
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。
文摘目的探讨在HPV阳性女性中,液基细胞学、DNA倍体分析及P16/Ki-67双染检测对宫颈癌前病变的分流作用。方法回顾性分析2021年5月至2022年12月在我院妇科行阴道镜及宫颈活检的妇女590例。患者高危人乳头瘤病毒(human papilloma virus,HPV)检测阳性,且行液基细胞学(liquid-based cytology,LBC)、DNA倍体分析、P16/Ki-67双染3种检查,对上述3种方法的灵敏度、特异性、受试者工作特征(receiver operating characteristic,ROC)曲线进行统计分析。结果液基细胞学、DNA倍体分析和P16/Ki-67双染3种筛查方法对宫颈癌前病变的灵敏度分别为84.2%、77.5%、76.4%,特异性分别为40.7%、49.2%、70.1%,曲线下面积(area under the curve,AUC)分别是0.625、0.634、0.733,其中,P16/Ki-67双染检测显著优于液基细胞学检查及DNA倍体分析(P<0.0001)。结论本研究认为,在HPV阳性女性中,P16/Ki-67双染检测的分流效果最佳。
基金Supported by Suzhou Science and Technology Project,No.SYS2019053.
文摘BACKGROUND Prostate cancer(PCa)is a widespread malignancy,predominantly affecting elderly males,and current methods for diagnosis and treatment of this disease continue to fall short.The marker Ki-67(MKI67)has been previously demonstrated to correlate with the proliferation and metastasis of various cancer cells,including those of PCa.Hence,verifying the association between MKI67 and the diagnosis and prognosis of PCa,using bioinformatics databases and clinical data analysis,carries significant clinical implications.AIM To explore the diagnostic and prognostic efficacy of antigens identified by MKI67 expression in PCa.METHODS For cohort 1,the efficacy of MKI67 diagnosis was evaluated using data from The Cancer Genome Atlas(TCGA)and Genotype-Tissue Expression(GTEx)databases.For cohort 2,the diagnostic and prognostic power of MKI67 expression was further validated using data from 271 patients with clinical PCa.RESULTS In cohort 1,MKI67 expression was correlated with prostate-specific antigen(PSA),Gleason Score,T stage,and N stage.The receiver operating characteristic(ROC)curve showed a strong diagnostic ability,and the Kaplan-Meier method demonstrated that MKI67 expression was negatively associated with the progression-free interval(PFI).The time-ROC curve displayed a weak prognostic capability for MKI67 expression in PCa.In cohort 2,MKI67 expression was significantly related to the Gleason Score,T stage,and N stage;however,it was negatively associated with the PFI.The time-ROC curve revealed the stronger prognostic capability of MKI67 in patients with PCa.Multivariate COX regression analysis was performed to select risk factors,including PSA level,N stage,and MKI67 expression.A nomogram was established to predict the 3-year PFI.CONCLUSION MKI67 expression was positively associated with the Gleason Score,T stage,and N stage and showed a strong diagnostic and prognostic ability in PCa.