摘要
目的探讨非小细胞肺癌(NSCLC)磁共振扩散加权成像(DWI)表观扩散系数(ADC)与肿瘤标记物及Ki-67表达的相关性。方法选取2018年8月至2019年6月就诊于陕西省核工业215医院肿瘤科的NSCLC患者37例,均使用3.0 T磁共振扫描仪行DWI(b=50、800 s/mm^2)检查。由2名有经验的放射科医生测量ADC,每个病灶测量3次,取平均值。使用组内相关系数(ICC)计算2名医生测量结果的一致性。使用电化学发光法在治疗前对所有患者行血清肿瘤标记物[包括糖类抗原(CEA)、鳞状细胞癌抗原(SCC)及细胞角蛋白19片段(CYFRA21-1)]检测。所有患者均通过外科手术或CT引导下穿刺活检或支气管镜检查获得病理结果,进而使用Spearman相关计算ADC与血清肿瘤标记物(CEA、SCC及CYFRA21-1)水平、Ki-67表达水平间的相关性。结果腺癌与鳞癌各项参数中,仅SCC在腺癌与鳞癌组差异有统计学意义(P=0.003),其余各项参数差异均无统计学意义(P>0.05)。Ki-67与CYFRA21-1呈正相关(r=0.359,P=0.029),ADC与SCC呈负相关趋势(r=-0.307,P=0.065),ADC与Ki-67无显著相关性(r=-0.089,P=0.599)。结论肿瘤标记物CYFRA21-1对预测NSCLC Ki-67表达水平有一定价值,有助于术前无创地评估肿瘤细胞的异常增殖状态;SCC可在一定程度上用来预测肿瘤组织的ADC,对判断肿瘤组织的恶性程度有潜在价值。
Objective To investigate the correlation between apparent diffusion coefficient(ADC)of magnetic resonance diffusion weighted imaging(DWI),tumor markers and Ki-67 expression in non-small cell lung carcinoma(NSCLC).Methods Thirty-seven NSCLC patients admitted to the oncology department of Nuclear Industry 215 Hospital of Shaanxi Province from August 2018 to June 2019 were selected,and all of them underwent DWI(b=50,800 s/mm2)examination using a 3.0 T magnetic resonance scanner.The ADC were measured by two experienced radiologists,the average values were acquired by three times measure-ment for each lesion.The intraclass correlation coefficient(ICC)was used to calculate the consistency of the ADC value measured by the two radiologists.Serum tumor markers including carcinoembryonic antigen(CEA),squamous cell carcinoma associated antigen(SCC)and cytokeratin 19 fragment(CYFRA21-1)were detected in all patients before treatment by electrochemiluminescence.Pathological results were obtained by surgical or CTguided puncture biopsy or bronchoscopy in all patients.Spearman correlation was used to calculate the correlation between ADC,serum tumor markers(CEA,SCC and CYFRA21-1)and Ki-67.Results Among the parameters of adenocarcinoma and squamous cell carcinoma,only SCC had statistical difference between the two group(P=0.003),and there was no statistical difference between the other parameters(P>0.05).Ki-67 was positively correlated with CYFRA21-1(r=0.359,P=0.029).There was a negative correlation trend between ADC and SCC(r=-0.307,P=0.065).There was no significant correlation between ADC and Ki-67(r=-0.089,P=0.599).Conclusion The tumor marker CYFRA21-1 is of certain value in predicting the expression level of Ki-67 in NSCLC and in assessment of the abnormal proliferation of tumor cells non-invasively before operation.To a certain extent,SCC expression level can be used to predict the ADC of tumor tissue,which has potential value in evaluating the malignant degree of tumor tissue.
作者
高翔
李朋
侯亚文
林赞
李升阳
李楠
GAO Xiang;LI Peng;HOU Yawen;LIN Zan;LI Shengyang;LI Nan(Department of Clinical Laboratory,Nuclear Industry 215 Hospital of Shaanxi Province,Xianyang,Shaanxi 712000,China;Department of Clinical Laboratory,Xidian Group Hospital,Xi'an,Shaanxi 710077,China)
出处
《检验医学与临床》
CAS
2020年第12期1636-1639,1643,共5页
Laboratory Medicine and Clinic
关键词
非小细胞肺癌
磁共振扩散加权成像
表观扩散系数
肿瘤标记物
KI-67
non-small cell lung carcinoma
magnetic resonance diffusion weighted imaging
apparent diffusion coefficient
tumor markers
Ki-67
