摘要
目的 探讨体素内不相干运动(intravoxel incoherent motion,IVIM)、魔镜成像(mDIXON-Quant)技术联合血细胞参数在评估直肠癌Ki-67表达水平中的应用价值。材料与方法 回顾性分析50例经病理证实为直肠癌患者的临床血常规和影像检查资料,测量病灶IVIM参数表观扩散系数(apparent diffusion coefficient,ADC)、纯扩散系数(pure apparent diffusion coefficient,D)、伪扩散系数(pseudo apparent diffusion coefficient,D^(*))、灌注分数(perfusion fraction,f)及mDixon-Quant参数脂肪分数(fat fraction,FF)、R2^(*)、T2^(*)。通过独立样本r检验或Mann-Whitney U检验比较各参数的差异。绘制受试者工作特征曲线(receiver operating characteristic,ROC)并计算曲线下面积(area under the curve,AUC)评价单一及联合参数预测直肠癌Ki-67表达状态的效能。采用Spearman相关性分析评价两组间有统计学意义的影像学和血细胞参数之间的关系。结果 Ki-67高表达组的R2^(*)值、FF值、中性粒细胞/淋巴细胞值(neutrophil to lymphocyte ratio,NLR)、系统免疫炎症指数(systemic immune inflammation index,SII)、全身炎症反应指数(systemic inflammatory response index,SIRI)高于Ki-67低表达组,而ADC值、D值低于Ki-67低表达组,差异均具有统计学意义(P<0.05)。ADC值、D值、R2^(*)值、FF值、NLR、SII、SIRI、影像学联合参数(ADC值+D值+R2^(*)值+FF值)及影像学参数联合血细胞参数(ADC值+D值+R2^(*)值+FF值+NLR+SII+SIRI)预测直肠癌Ki-67表达状态的AUC分别为0.691、0.775、0.739、0.724、0.784、0.726、0.718、0.839及0.906;影像学联合血细胞参数的诊断效能较各单一参数的诊断效能得到了明显提升。Spearman相关性分析显示Ki-67高表达组中FF值与SII呈正相关,差异具有统计学意义(r=0.525,P=0.012)。结论 IVIM、mDixon-Quant及血细胞参数均能有效判断直肠癌Ki-67表达水平,且影像学联合血细胞参数可明显提升鉴别诊断的效能。癌症的异常脂质代谢导致肿瘤病灶内脂肪沉积,可能会引起炎症反应的发生。
Objective:To investigate the application value of intravoxel incoherent motion(IVIM),mDixon‐Quant combined with blood cell parameters in evaluating Ki‐67 expression levels in rectal cancer.Materials and Methods:Clinical routine blood count and imaging examination data of 50 patients with clinicopathologically confirmed rectal cancer were retrospectively analyzed.We measured IVIM parameters apparent diffusion coefficient(ADC),pure apparent diffusion coefficient(D),pseudo apparent diffusion coefficient(D^(*)),perfusion fraction(f)and mDixon‐Quant parameters fat fraction(FF),R2^(*),T2^(*)of the lesion.Independent sample t test or Mann‐Whitney U test was used to compare the differences in the parameters.The efficacy of single and combined parameters in predicting Ki-67 expression status in rectal cancer was evaluated by plotting receiver operating characteristic(ROC)curves and calculating the area under the curve(AUC).Spearman test was used to evaluate the relationship between statistically significant imaging and blood cell parameters between the two groups.Results:R2^(*)value,FF value,neutrophil to lymphocyte ratio(NLR),systemic immune inflammation index(SII),systemic inflammatory response index(SIRI)of the Ki‐67 high expression group were higher than those of the Ki-67 low expression group,ADC value,D value of the Ki-67 high expression group were lower than those of the Ki-67 low expression group,and the differences were all statistically significant(P<0.05).The AUC of ADC value,D value,R2^(*)value,FF value,NLR,SII,SIRI,imaging association parameters(ADC+D+R2^(*)+FF)and imaging combined with blood cell parameters(ADC+D+R2^(*)+FF+NLR+SII+SIRI)for evaluating the Ki-67 expression status of rectal cancer were 0.691,0.775,0.739,0.724,0.784,0.726,0.718,0.839 and 0.906,respectively.The diagnostic efficiency of imaging combined with blood cell parameters was significantly improved compared to single parameters.Spearman test showed a positive correlation between FF values and SII in the Ki‐67 high expression group,and the difference was statistically significant(r=0.525,P=0.012).Conclusions:IVIM,mDixon‐Quant and blood cell parameters are effective in determining Ki‐67 expression levels in rectal cancer,and the imaging combined with blood cell parameters can significantly improve the effectiveness of differential diagnosis.Abnormal lipid metabolism in cancer leads to fat deposition within the tumor lesion,which may cause an inflammatory response to develop.
作者
赵雅迪
李伟兰
宋健
周伟
薛慧
李垣婕
王志强
谢宗源
ZHAO Yadi;LI Weilan;SONG Jian;ZHOU Wei;XUE Hui;LI Yuanjie;WANG Zhiqiang;XIE Zongyuan(Department of MRI,North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China;Department of Hematology,North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2024年第8期145-151,共7页
Chinese Journal of Magnetic Resonance Imaging
基金
河北省卫生健康委医学科学研究项目(编号:20231273)。
作者简介
通信作者:谢宗源,E-mail:93347795@qq.com。
