摘要
目的探讨直肠中分化腺癌细胞增殖指数Ki-67表达与MRI形态学、表观扩散系数(ADC)之间的相关性。方法纳入经病理证实直肠中分化腺癌且术前均进行常规MRI平扫、动脉增强扫描及弥散加权成像(DWI)检查患者183例,分析其MRI形态学特点并与免疫组Ki-67表达进行对比分析。结果183例直肠中分化腺癌细胞增殖指数Ki-67指数为20%-70%,其中高表达121例、低表达62例,高表达组与低表达组病变多以边界不清、不规则、卵圆形不均质强化改变,MRI-TIC曲线上表现各异;无直肠周围淋巴结转移97例、Ki-67均值为(50.13±12.39)%,伴淋巴结转移的85例、Ki-67均值为(62.13±9.47)%,两组Ki-67指数间具有统计学差异(P<0.05);中分化腺癌伴坏死者84例、Ki-67均值为(41.06±10.21)%,无坏死者99例、Ki-67均值为(32.11±14.36)%,两组Ki-67指数差异性显著(P<0.05);Ki-67指数与肿瘤大小、边界、内部强化、直肠系膜筋膜有无侵蚀、有无脉管癌栓、ADC值间无显著相关性(P>0.05)。结论直肠中分化腺癌的MRI形态学特征中,肿块内局部坏死及直肠周围淋巴结转移对于预测肿瘤细胞增殖指数Ki-67表达具有重要意义。
Objective To investigate the correlation between the expression of Ki-67 and the morphology and apparent diffusion coefficient(ADC)of rectal moderately differentiated adenocarcinoma cells.Methods 183 patients with moderately differentiated adenocarcinoma of rectum confirmed by pathology and examined by routine MRI plain scan,arterial contrast-enhanced scan and diffusion-weighted imaging(DWI)before operation were enrolled.The morphological characteristics of MR were analyzed and compared with the expression of Ki-67 in immune group.Results Ki-67 index was 20%-70%in 183 cases of moderately differentiated adenocarcinoma of rectum,including 121 cases with high expression and 62 cases with low expression.The lesions in high expression group and low expression group were mostly enhanced with unclear boundary,irregular and oval heterogeneity.The expression of Ki-67 index was different on the MRI-TIC curve;97 cases without perirectal lymph node metastasis,the mean value of Ki-67 was(50.13±12.39)%,85 cases with lymph node metastasis,and the mean value of Ki-67 was(62.13±9.47)%.There was statistical difference between the two groups(P<0.05);84 cases with moderately differentiated adenocarcinoma and necrosis,the mean value of Ki-67 was(41.13±9.47)%.The mean value of Ki-67 in 99 cases without necrosis was(32.11±14.36)%.There was significant difference in Ki-67 index between the two groups(P<0.05);There was no significant correlation between Ki-67 index and tumor size,boundary,internal enhancement,mesorectal fascia erosion,vascular thrombus and ADC value(P>0.05).Conclusion Among the morphological features of rectal moderately differentiated adenocarcinoma,local necrosis and perirectal lymph node metastasis play an important role in predicting the expression of Ki-67.
作者
王军大
杨雅淋
李艳艳
WANG Jun-da;YANG Ya-ling;LI Yan-yan(Department of Radiology,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China;Department of Pharmacy,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)
出处
《中国CT和MRI杂志》
2022年第10期128-130,共3页
Chinese Journal of CT and MRI
基金
重庆市卫生计生委中医药科技项目(No.ZY201802025)
重庆市自然科学基金面上项目(No.cstc2019jcyjmsxmX0555)
2019年度“杏林学者”学科人才科研提升计划(No.YYZX2019064)。
关键词
直肠中分化腺癌
KI-67
ADC
Medium Differentiated Adenocarcinoma of Rectum
Ki-67
ADC
