肝外胆管癌IVIM-DWI参数值与Ki-67表达的相关性
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摘要
目的探讨肝外胆管癌(EHCC)体素内不相干运动磁共振扩散加权成像(IVIM-DWI)参数值与Ki-67表达之间的相关性。方法搜集经手术病理证实的41例EHCC患者完整资料,术前均行3.0 T磁共振常规及IVIM-DWI序列扫描,术后采用免疫组织化学染色记录分子预后标记物Ki-67的表达情况。按Ki-67表达差异,将患者分为4组,分别计算各组肿瘤的IVIM-DWI参数值,包括真性扩散系数(D)值、灌注分数(f)值和假性扩散系数(D~*)值。采用Spearman相关分析研究IVIM-DWI各参数与Ki-67表达的相关性。结果 41例EHCC患者按照Ki-67的表达情况分为4组,Ⅰ组5例,Ⅱ组13例,Ⅲ组16例,Ⅳ组7例。不同Ki-67表达组间除D~*值的差异无统计学意义(P>0.05)外,其余参数的差异均有统计学意义(P<0.05)。D值和f值均与Ki-67表达水平呈负相关(r值分别为-0.753、-0.526,P均<0.05)。结论 IVIM-DWI技术可以在一定程度上反映EHCC肿瘤细胞的增殖活性,对术前预测肿瘤恶性增殖的生物学行为具有临床价值。
Objective To investigate the correlation between parameter values of intravoxel incoherent motion(IVIM) MR diffusion-weighted imaging(DWI)and Ki-67 expression in extrahepatic cholangiocarcinoma. Methods 41 patients with EHCC confirmed pathologically underwent preoperative conventional MRI and IVIM sequence scan. The expression of molecular prognostic marker Ki-67 was recorded by immunohistochemical staining. According to the Ki-67 expression difference,the patients were divided into Ⅰ-Ⅳ four Groups. The parameter values such as pure molecular diffusion(D),perfusion fraction(f) and perfusion-based molecular diffusion(D~*) were calculated in each group. Spearman correlation analysis was used to study the correlation between the parameters of IVIM-DWI and the Ki-67 expression. Results 41 cases of EHCC were divided into 5 cases in group Ⅰ,13 cases in group Ⅱ,16 in group Ⅲ and 7 in group Ⅳ according to the expression of Ki-67. The difference of D~* values between different Ki-67 groups was not statistically significant(P>0.05),and the differences of the other parameters were statistically significant(P<0.05). D and f values correlated negatively with Ki-67 expression(r=-0.753,-0.526,P<0.05). Conclusion IVIM-DWI technology can reflect the proliferative activity of tumor cells of extrahepatic cholangiocarcinoma to a certain extent,and has clinical value for predicting the biological behavior of malignant proliferation before operation.
Objective To investigate the correlation between parameter values of intravoxel incoherent motion(IVIM) MR diffusion-weighted imaging(DWI)and Ki-67 expression in extrahepatic cholangiocarcinoma. Methods 41 patients with EHCC confirmed pathologically underwent preoperative conventional MRI and IVIM sequence scan. The expression of molecular prognostic marker Ki-67 was recorded by immunohistochemical staining. According to the Ki-67 expression difference,the patients were divided into Ⅰ-Ⅳ four Groups. The parameter values such as pure molecular diffusion(D),perfusion fraction(f) and perfusion-based molecular diffusion(D~*) were calculated in each group. Spearman correlation analysis was used to study the correlation between the parameters of IVIM-DWI and the Ki-67 expression. Results 41 cases of EHCC were divided into 5 cases in group Ⅰ,13 cases in group Ⅱ,16 in group Ⅲ and 7 in group Ⅳ according to the expression of Ki-67. The difference of D~* values between different Ki-67 groups was not statistically significant(P>0.05),and the differences of the other parameters were statistically significant(P<0.05). D and f values correlated negatively with Ki-67 expression(r=-0.753,-0.526,P<0.05). Conclusion IVIM-DWI technology can reflect the proliferative activity of tumor cells of extrahepatic cholangiocarcinoma to a certain extent,and has clinical value for predicting the biological behavior of malignant proliferation before operation.
引文
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5于学娟,柳善刚,陈兆秋,等.3.0T磁共振成像表观扩散系数与乳腺浸润性导管癌组织学分级及分子生物学特征的相关性[J].中华肿瘤杂志,2014,36:606-611.
6王铮,苏丹柯,赖少侣,等.直肠癌磁共振扩散加权成像ADC值与Ki-67表达水平的相关性[J].实用放射学杂志,2016,32:551-553.
7 Hambrock T,Somford DM,Huisman HJ,et al.Relationship between apparent diffusion coefficients at 3.0-T MR imaging and Gleason grade in peripheral zone prostate cancer[J].Radiology,2011,259:453-461.
8 Iima M,Le Bihan D,Okumura R,et al.Apparent diffusion coefficient as an MR imaging biomarker of low-risk ductal carcinoma in situ:a pilot study[J].Radiology,2011,260:364-372.
9 Hu XX,Yang ZX,Liang HY,et al.Whole-tumor MRI histogram analyses of hepatocellular carcinoma:Correlations with Ki-67 labeling index[J].J Magn Reson Imaging,2017,46:383-392.
10 Le Bihan D,Breton E,Lallemand D,et al.Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging[J].Radiology,1988,168:497-505.
11 Surov A,Meyer HJ,H9hn AK,et al.Correlations between intravoxel incoherent motion(IVIM)parameters and histological findings in rectal cancer:preliminary results[J].Oncotarget.2017,8:21974-21983.
12 Lee YJ,Kim SH,Kang BJ,et al.Intravoxel incoherent motion(IVIM)-derived parameters in diffusion-weighted MRI:Associations with prognostic factors in invasive ductal carcinoma[J].J Magn Reson Imaging,2017,45:1394-1406.
13 Yiping L,Kawai S,Jianbo W,et al.Evaluation parameters between intra-voxel incoherent motion and diffusion-weighted imaging in grading and differentiating histological subtypes of meningioma:Aprospective pilot study[J].J Neurol Sci,2017,372:60-69.
14黄波,赵国忠.AnnexinⅡ和Ki-67在胆管癌中的表达及意义[J].临床肝胆病杂志,2011,27:178-180.
15 Zhang YD,Wang Q,Wu CJ,et al.The histogram analysis of diffusion-weighted intravoxel incoherent motion(IVIM)imaging for differentiating the gleason grade of prostate cancer[J].Eur Radiol,2015,25:994-1004.
16 Woo S,Lee JM,Yoon JH,et al.Intravoxel incoherent motion diffusion-weighted MR imaging of hepatocellular carcinoma:correlation with enhancement degree and histologic grade[J].Radiology,2014,270:758-767.
17崔兴宇,蔡崧,汤群锋,等.IVIM-DWI在肝外胆管癌分级中的临床应用[J].临床放射学杂志,2016,35:1380-1384.
18王余,彭鹏,张宇新,等.磁共振扩散加权成像评价肝外胆管癌肿瘤血管生成及病理分级的价值[J].临床放射学杂志,2014,33:248-254.
2 Friman S.Cholangiocarcinoma-current treatment options[J].Scand J Surg,2011,100:30-34.
3 Matsuo K,Rocha FG,Ito K,et al.The Blumgart preoperative staging system for hilar cholangiocarcinoma:analysis of resectability and outcomes in 380 patients[J].J Am Coll Surg,2012,215:343-355.
4 Inwald EC,Klinkhammer-Schalke M,Hofstdter F,et al.Ki-67 is a prognostic parameter in breast cancer patients:results of a large population-based cohort of a cancer registry[J].Breast Cancer Res Treat,2013,139:539-552.
5于学娟,柳善刚,陈兆秋,等.3.0T磁共振成像表观扩散系数与乳腺浸润性导管癌组织学分级及分子生物学特征的相关性[J].中华肿瘤杂志,2014,36:606-611.
6王铮,苏丹柯,赖少侣,等.直肠癌磁共振扩散加权成像ADC值与Ki-67表达水平的相关性[J].实用放射学杂志,2016,32:551-553.
7 Hambrock T,Somford DM,Huisman HJ,et al.Relationship between apparent diffusion coefficients at 3.0-T MR imaging and Gleason grade in peripheral zone prostate cancer[J].Radiology,2011,259:453-461.
8 Iima M,Le Bihan D,Okumura R,et al.Apparent diffusion coefficient as an MR imaging biomarker of low-risk ductal carcinoma in situ:a pilot study[J].Radiology,2011,260:364-372.
9 Hu XX,Yang ZX,Liang HY,et al.Whole-tumor MRI histogram analyses of hepatocellular carcinoma:Correlations with Ki-67 labeling index[J].J Magn Reson Imaging,2017,46:383-392.
10 Le Bihan D,Breton E,Lallemand D,et al.Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging[J].Radiology,1988,168:497-505.
11 Surov A,Meyer HJ,H9hn AK,et al.Correlations between intravoxel incoherent motion(IVIM)parameters and histological findings in rectal cancer:preliminary results[J].Oncotarget.2017,8:21974-21983.
12 Lee YJ,Kim SH,Kang BJ,et al.Intravoxel incoherent motion(IVIM)-derived parameters in diffusion-weighted MRI:Associations with prognostic factors in invasive ductal carcinoma[J].J Magn Reson Imaging,2017,45:1394-1406.
13 Yiping L,Kawai S,Jianbo W,et al.Evaluation parameters between intra-voxel incoherent motion and diffusion-weighted imaging in grading and differentiating histological subtypes of meningioma:Aprospective pilot study[J].J Neurol Sci,2017,372:60-69.
14黄波,赵国忠.AnnexinⅡ和Ki-67在胆管癌中的表达及意义[J].临床肝胆病杂志,2011,27:178-180.
15 Zhang YD,Wang Q,Wu CJ,et al.The histogram analysis of diffusion-weighted intravoxel incoherent motion(IVIM)imaging for differentiating the gleason grade of prostate cancer[J].Eur Radiol,2015,25:994-1004.
16 Woo S,Lee JM,Yoon JH,et al.Intravoxel incoherent motion diffusion-weighted MR imaging of hepatocellular carcinoma:correlation with enhancement degree and histologic grade[J].Radiology,2014,270:758-767.
17崔兴宇,蔡崧,汤群锋,等.IVIM-DWI在肝外胆管癌分级中的临床应用[J].临床放射学杂志,2016,35:1380-1384.
18王余,彭鹏,张宇新,等.磁共振扩散加权成像评价肝外胆管癌肿瘤血管生成及病理分级的价值[J].临床放射学杂志,2014,33:248-254.
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