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乳腺癌磁共振表观扩散系数与Ki-67表达的相关性

Correlation between MRI apparent diffusion coefficient value and Ki-67 index in patients with breast cancer

    摘要
  • 摘要:
    目的 探讨乳腺癌磁共振表观扩散系数（apparent diffusion coefficient，ADC）与Ki-67表达的相关性。
    方法 回顾性分析120例经手术证实的乳腺癌术前扩散加权成像（diffusion weighted imaging，DWI）的磁共振影像（b=0、800、1 000 s/mm2），并测量其ADC值，分析ADC值与Ki-67指数的相关性。根据Ki-67指数的不同分为A组（低Ki-67组，n=60）和B组（高Ki-67组，n=60），比较两组间的ADC值并采用受试者工作特征（receiver operating characteristics，ROC）曲线分析ADC值鉴别诊断价值。
    结果 乳腺癌测量的ADC值与Ki-67指数明显负相关（rb值800=-0.587，rb值1 000=-0.63，P < 0.000 1）。相同b值下，B组的平均ADC值明显小于A组（P < 0.000 1）。b值为1 000 s/mm2时的平均ADC值小于同组b值800 s/mm2的平均ADC值。当b值为800、1 000 s/mm2时，分别以ADC值1 954.00、1 521.00（10-6 mm2/s）为临界值，鉴别诊断A、B组乳腺癌的ROC曲线下面积分别为0.91、0.94，敏感度分别为73.30%、83.00%，特异度分别为95.00%、91.70%。
    结论 MRI ADC值与乳腺癌Ki-67指数表达明显相关，值得进一步研究以应用于临床指导乳腺癌术前诊治。

     

    Abstract:
    Objective To explore the relationship between MRI apparent diffusion coefficient (ADC) value and Ki-67 index in patients with breast cancer.
    Methods The preoperative MRI diffusion weighted imaging (DWI) images (b=0, 800, 1000 s/mm2) of 120 patients with surgically confirmed breast cancer were retrospectively analyzed, and the ADC values were measured. The correlation between the ADC value and Ki-67 index was analyzed. According to the different Ki-67 index, they were divided into group A (low Ki-67 group, n=60) and group B (high Ki-67 group, n=60). ADC values between the two groups were compared and the identification ability of ADC value was analyzed by receiver operating characteristics (ROC) curve.
    Results The ADC value of breast cancer was negatively correlated with Ki-67 index (rb value 800=-0.587, rb value 1 000=-0.63, P < 0.000 1). Under the same B value, the average ADC value of group B was significantly lower than that of group A (P < 0.000 1). When b value was 1 000 s/mm2, the average ADC value was lower than that of 800 s/mm2 in the same group. When the b value was 800 or 1 000 s/mm2, using 1 954.00 or 1 521.00 (10-6 s/mm2) as the critical ADC values respectively, the area under the ROC curve for differential diagnosis of breast cancer in group A and B was 0.91 or 0.94, respectively. The sensitivity was 73.30% or 83.00%, and the specificity was 95.00% or 91.70%, respectively.
    Conclusions ADC value has an important predictive value for the expression of Ki-67 index in patients with breast cancer.

     

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