目的:探讨表观弥散系数(apparent diffusion coefficient,ADC)鉴别诊断脑膜瘤组织病理学分级的价值及其与Ki-67增殖指数的关系。方法:回顾并分析经术后病理学检查证实为脑膜瘤的51例患者资料,根据世界卫生组织(World Health Organizatio...目的:探讨表观弥散系数(apparent diffusion coefficient,ADC)鉴别诊断脑膜瘤组织病理学分级的价值及其与Ki-67增殖指数的关系。方法:回顾并分析经术后病理学检查证实为脑膜瘤的51例患者资料,根据世界卫生组织(World Health Organization,WHO)病理学分级分为低级别脑膜瘤(low-grade meningioma,LGM)组45例和高级别脑膜瘤(high-grade meningioma,HGM)组6例,计算平均ADC(ADC_(mean))、最小ADC(ADC_(min)),以及两者相对值(rADC_(mean)、rADC_(min))。比较两组ADC_(mean)、ADC_(min)、rADC_(mean)、rADC_(min)的差异。绘制受试者工作特征(receiver operating characteristic,ROC)曲线评估ADC各参数的鉴别诊断效能,并采用DeLong检验比较ROC曲线的曲线下面积(area under the curve,AUC)的差异。采用Spearman相关分析评估ADC各参数与Ki-67增殖指数之间的相关性。结果:LGM组的ADC_(mean)、ADC_(min)、rADC_(mean)及rADC_(min)均高于HGM组,组间差异有统计学意义(P<0.05)。4种ADC参数均有较好的诊断效能,DeLong检验显示AUC两两比较差异均无统计学意义(P>0.05),其中ADC_(min)的鉴别诊断效能最高,其最佳截断值为0.657×10^(-3)mm^(2)/s,灵敏度为66.67%,特异度为95.56%。ADC_(mean)、ADC_(min)、rADC_(mean)及rADC_(min)均与Ki-67增殖指数呈负相关(P<0.05)。结论:ADC有助于术前预测脑膜瘤的病理学分级及Ki-67增殖指数,可为临床诊疗提供支持。展开更多
Objective: To explore the correlation between the spectral computed tomography(CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma.Methods: Spectral CT imaging parameters [iodine concentrations ...Objective: To explore the correlation between the spectral computed tomography(CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma.Methods: Spectral CT imaging parameters [iodine concentrations of lesions(ICLs) in the arterial phase(ICLa)and venous phase(ICLv), normalized IC in the aorta(NICa/NICv), slope of the spectral HU curve(λHUa/λHUv)and monochromatic CT number enhancement on 40 keV and 70 keV images(CT40 keVa/v, CT70keVa/v)] in 34 lung adenocarcinomas were analyzed, and common molecular markers, including the Ki-67 labeling index, were detected with immunohistochemistry. Different Ki-67 labeling indexes were measured and grouped into four grades according to the number of positive-stained cells(grade 0, ≤1%;1%<grade 1≤10%;10%<grade 2≤30%;and grade 3, >30%). One-way analysis of variance(ANOVA) was used to compare the four different grades, and the Bonferroni method was used to correct the P value for multiple comparisons. A Spearman correlation analysis was performed to further research a quantitative correlation between the Ki-67 labeling index and spectral CT imaging parameters.Results: CT40keVa, CT40 keVv, CT70keVa and CT70keVv increased as the grade increased, and CT70keVa and CT70keVv were statistically significant(P<0.05). These four parameters and the Ki-67 labeling index showed a moderate positive correlation with lung adenocarcinoma nodules. ICL, NIC and λHU in the arterial and venous phases were not significantly different among the four grades.Conclusions: The spectral CT imaging parameters CT40keVa, CT40keVv, CT70keVa and CT70keVv gradually increased with Ki-67 expression and showed a moderate positive correlation with lung adenocarcinomas.Therefore, spectral CT imaging parameter-enhanced monochromatic CT numbers at 70 keV may indicate the extent of proliferation of lung adenocarcinomas.展开更多
Introduction: Meningiomas are the most common type of extra-axial neoplasm. Peritumoral brain edema (PTBE) can be seen around meningiomas while it may be absent in others. Despite that Ki67 proliferative index has bee...Introduction: Meningiomas are the most common type of extra-axial neoplasm. Peritumoral brain edema (PTBE) can be seen around meningiomas while it may be absent in others. Despite that Ki67 proliferative index has been previously correlated with meningioma grades, no definite relationship has been established in relation to PTBE in meningioma patients. Objective: Correlate the peritumoral brain edema with the Ki67 proliferative index of meningiomas. Patients & Methods: Aclinical prospective study was conducted on 56 patients (47 women, 9 men;mean age 50.89 ± 12.55 years) diagnosed with meningiomas. All patients were evaluated regarding the presence of brain edema surrounding the lesion in pre-operative neuroimaging using T2W and FLAIR MR images. Immunohistochemical staining of Ki67 index (representing proliferative activity) was done. Correlation between presence of PTBE and Ki67 index values was evaluated. Results: PTBE was found in nearly half of the patients (48.2%), while the remaining (51.8%) of patients did not exhibit PTBE in their pre-operative neuroimaging. The mean value of Ki67 index in meningioma patients with PTBE was 4.83% compared to a value of 1.83% in patients without PTBE, P value = 0.014. Conclusion: High Ki67 indices are evident in meningiomas with surrounding peritumoral brain edema (PTBE).展开更多
Background: The purpose of this study was to elucidate the association between sentinel lymph node (SLN) metastasis and Ki67 labeling index and to elucidate whether Ki-67 was useful or not for prediction of SLN metast...Background: The purpose of this study was to elucidate the association between sentinel lymph node (SLN) metastasis and Ki67 labeling index and to elucidate whether Ki-67 was useful or not for prediction of SLN metastasis in breast cancer. Methods: We identified 343 invasive breast cancer patients with sentinel lymph node biopsy (SLNB) from 2003 to 2012. The association between SLN status and clinicopathological features, molecular subtypes and Ki-67 labeling index were evaluated. Results: SLN metastasis was detected in 79 patients (23.0%). SLN metastasis was significantly associated with clinical T-stage (p = 0.0003), lymphovascular involvement (LVI) (p 0.0001). Ki-67 labeling index of primary tumor was significantly lower in SLN positive patients (p = 0.0331), and Ki-67 cut-off point of 7.5% was useful for dividing SLN positive from negative (p = 0.0197). Conclusion: Low value of Ki-67 labeling index, in addition to progression of clinical T-stage and presence of LVI, is significantly associated with SLN metastasis, and it seems to be useful to consider Ki-67 labeling index for SLN metastasis prediction.展开更多
在噪声干扰较强的环境下,为了克服傅里叶分解方法(Fourier Decomposition Method,FDM)在分析调制信号及单独使用调制信号双谱(Modulated Signal Bispectrum,MSB)在分析非平稳信号方面的不足,提出了一种FDM和MSB相结合的滚动轴承故障诊...在噪声干扰较强的环境下,为了克服傅里叶分解方法(Fourier Decomposition Method,FDM)在分析调制信号及单独使用调制信号双谱(Modulated Signal Bispectrum,MSB)在分析非平稳信号方面的不足,提出了一种FDM和MSB相结合的滚动轴承故障诊断方法。首先,使用FDM按照高频到低频的方式搜寻傅里叶固有模态函数分量(Fourier Intrinsic band Functions,FIBFs);以加权峭度指标作为评判标准,对信号进行重构,确保得到最佳的信号;然后对新的信号利用MSB分析方法进行解调处理,最终通过复合切片谱实现故障特征频率的提取。最后,通过上述方法对模拟信号和滚动轴承外圈故障信号进行分析,其研究结果表明:该方法能够有效地提取故障特征频率,并且与常规双谱进行对比,验证所提方法的优越性。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:探讨表观弥散系数(apparent diffusion coefficient,ADC)鉴别诊断脑膜瘤组织病理学分级的价值及其与Ki-67增殖指数的关系。方法:回顾并分析经术后病理学检查证实为脑膜瘤的51例患者资料,根据世界卫生组织(World Health Organization,WHO)病理学分级分为低级别脑膜瘤(low-grade meningioma,LGM)组45例和高级别脑膜瘤(high-grade meningioma,HGM)组6例,计算平均ADC(ADC_(mean))、最小ADC(ADC_(min)),以及两者相对值(rADC_(mean)、rADC_(min))。比较两组ADC_(mean)、ADC_(min)、rADC_(mean)、rADC_(min)的差异。绘制受试者工作特征(receiver operating characteristic,ROC)曲线评估ADC各参数的鉴别诊断效能,并采用DeLong检验比较ROC曲线的曲线下面积(area under the curve,AUC)的差异。采用Spearman相关分析评估ADC各参数与Ki-67增殖指数之间的相关性。结果:LGM组的ADC_(mean)、ADC_(min)、rADC_(mean)及rADC_(min)均高于HGM组,组间差异有统计学意义(P<0.05)。4种ADC参数均有较好的诊断效能,DeLong检验显示AUC两两比较差异均无统计学意义(P>0.05),其中ADC_(min)的鉴别诊断效能最高,其最佳截断值为0.657×10^(-3)mm^(2)/s,灵敏度为66.67%,特异度为95.56%。ADC_(mean)、ADC_(min)、rADC_(mean)及rADC_(min)均与Ki-67增殖指数呈负相关(P<0.05)。结论:ADC有助于术前预测脑膜瘤的病理学分级及Ki-67增殖指数,可为临床诊疗提供支持。
基金supported by National Natural Science Foundation of China (No. 91959116)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (No. ZYLX 201803)+1 种基金“Beijing Hospitals Authority” Ascent Plan (No. DFL20191103)National Key R&D Program of China (No. 2017YFC1309101, 2017YFC1309104).
文摘Objective: To explore the correlation between the spectral computed tomography(CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma.Methods: Spectral CT imaging parameters [iodine concentrations of lesions(ICLs) in the arterial phase(ICLa)and venous phase(ICLv), normalized IC in the aorta(NICa/NICv), slope of the spectral HU curve(λHUa/λHUv)and monochromatic CT number enhancement on 40 keV and 70 keV images(CT40 keVa/v, CT70keVa/v)] in 34 lung adenocarcinomas were analyzed, and common molecular markers, including the Ki-67 labeling index, were detected with immunohistochemistry. Different Ki-67 labeling indexes were measured and grouped into four grades according to the number of positive-stained cells(grade 0, ≤1%;1%<grade 1≤10%;10%<grade 2≤30%;and grade 3, >30%). One-way analysis of variance(ANOVA) was used to compare the four different grades, and the Bonferroni method was used to correct the P value for multiple comparisons. A Spearman correlation analysis was performed to further research a quantitative correlation between the Ki-67 labeling index and spectral CT imaging parameters.Results: CT40keVa, CT40 keVv, CT70keVa and CT70keVv increased as the grade increased, and CT70keVa and CT70keVv were statistically significant(P<0.05). These four parameters and the Ki-67 labeling index showed a moderate positive correlation with lung adenocarcinoma nodules. ICL, NIC and λHU in the arterial and venous phases were not significantly different among the four grades.Conclusions: The spectral CT imaging parameters CT40keVa, CT40keVv, CT70keVa and CT70keVv gradually increased with Ki-67 expression and showed a moderate positive correlation with lung adenocarcinomas.Therefore, spectral CT imaging parameter-enhanced monochromatic CT numbers at 70 keV may indicate the extent of proliferation of lung adenocarcinomas.
文摘Introduction: Meningiomas are the most common type of extra-axial neoplasm. Peritumoral brain edema (PTBE) can be seen around meningiomas while it may be absent in others. Despite that Ki67 proliferative index has been previously correlated with meningioma grades, no definite relationship has been established in relation to PTBE in meningioma patients. Objective: Correlate the peritumoral brain edema with the Ki67 proliferative index of meningiomas. Patients & Methods: Aclinical prospective study was conducted on 56 patients (47 women, 9 men;mean age 50.89 ± 12.55 years) diagnosed with meningiomas. All patients were evaluated regarding the presence of brain edema surrounding the lesion in pre-operative neuroimaging using T2W and FLAIR MR images. Immunohistochemical staining of Ki67 index (representing proliferative activity) was done. Correlation between presence of PTBE and Ki67 index values was evaluated. Results: PTBE was found in nearly half of the patients (48.2%), while the remaining (51.8%) of patients did not exhibit PTBE in their pre-operative neuroimaging. The mean value of Ki67 index in meningioma patients with PTBE was 4.83% compared to a value of 1.83% in patients without PTBE, P value = 0.014. Conclusion: High Ki67 indices are evident in meningiomas with surrounding peritumoral brain edema (PTBE).
文摘Background: The purpose of this study was to elucidate the association between sentinel lymph node (SLN) metastasis and Ki67 labeling index and to elucidate whether Ki-67 was useful or not for prediction of SLN metastasis in breast cancer. Methods: We identified 343 invasive breast cancer patients with sentinel lymph node biopsy (SLNB) from 2003 to 2012. The association between SLN status and clinicopathological features, molecular subtypes and Ki-67 labeling index were evaluated. Results: SLN metastasis was detected in 79 patients (23.0%). SLN metastasis was significantly associated with clinical T-stage (p = 0.0003), lymphovascular involvement (LVI) (p 0.0001). Ki-67 labeling index of primary tumor was significantly lower in SLN positive patients (p = 0.0331), and Ki-67 cut-off point of 7.5% was useful for dividing SLN positive from negative (p = 0.0197). Conclusion: Low value of Ki-67 labeling index, in addition to progression of clinical T-stage and presence of LVI, is significantly associated with SLN metastasis, and it seems to be useful to consider Ki-67 labeling index for SLN metastasis prediction.
文摘目的根据初次确诊垂体神经内分泌肿瘤(pituitary neuroendocrine tumors,PitNETs)患者ki-67指数升高的危险因素的验证结果,构建术前预测瘤体组织ki-67指数的预测模型。方法采用病例-对照研究设计方案,收集2015年1月至2019年12月在陆军军医大学第二附属医院初次确诊的449名PitNETs患者术前的临床资料及瘤体组织标本病理结果。以7∶3的比例随机分为训练集(n=314)和验证集(n=135)。以ki-67表达水平≥3%为标准分为低水平组和高水平组,分析比较两组患者的临床资料。在训练集中进行多因素LASSO回归和二元Logistic回归识别ki-67指数的独立危险因素并构建列线图,应用受试者操作曲线下面积(area under the subject curve,AUC)、校准曲线(采用1000次的Bootstrap法获得)和决策曲线(decision curve analysis,DCA)来评估该模型的预测效能;在验证集中进行外部验证。结果经LASSO回归和二元Logistic回归筛选后结果显示:年龄(OR=0.97,95%CI:0.95~0.99)、肿瘤最大直径(OR=1.56,95%CI:1.21~2.03)及游离甲状腺素(free thyroxine,FT4;OR=0.93,95%CI:0.87~0.99)为ki-67指数升高的独立危险因素,并根据上述3个变量构建列线图模型;该模型在训练集和验证集中的AUC分别为0.692(95%CI:0.6294~0.7551)和0.691(95%CI:0.5913~0.7901),校准曲线均显示预测值与实测值拟合性良好,临床决策曲线表明在0.1~0.35阈值范围内有净收益率提示该模型有一定临床意义。结论初诊PitNETs患者的年龄、肿瘤最大直径及FT4为ki-67指数升高的独立危险因素;构建列线图模型在术前预测出ki-67指数表达水平的区分度和校准度较高,对手术方案选择和术后管理有一定帮助。
文摘在噪声干扰较强的环境下,为了克服傅里叶分解方法(Fourier Decomposition Method,FDM)在分析调制信号及单独使用调制信号双谱(Modulated Signal Bispectrum,MSB)在分析非平稳信号方面的不足,提出了一种FDM和MSB相结合的滚动轴承故障诊断方法。首先,使用FDM按照高频到低频的方式搜寻傅里叶固有模态函数分量(Fourier Intrinsic band Functions,FIBFs);以加权峭度指标作为评判标准,对信号进行重构,确保得到最佳的信号;然后对新的信号利用MSB分析方法进行解调处理,最终通过复合切片谱实现故障特征频率的提取。最后,通过上述方法对模拟信号和滚动轴承外圈故障信号进行分析,其研究结果表明:该方法能够有效地提取故障特征频率,并且与常规双谱进行对比,验证所提方法的优越性。
