多参数磁共振成像在前列腺癌患者诊断中的应用及其与组织Ki-67表达水平的关系

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目的:探究多参数磁共振成像在前列腺癌患者诊断中的应用,分析各参数与组织Ki-67表达水平的关系。方法:选择2018年6月至2019年6月河北省秦皇岛市第二医院术前行多参数磁共振成像的疑似前列腺癌患者100例作为研究对象,以术前穿刺活检病理为金标准,证实50例为前列腺癌患者,50例为前列腺增生患者,比较两组患者影像学特点;同时前列腺癌患者经直肠超声引导下会阴前列腺穿刺活检,检测前列腺组织中Ki-67的表达,分析多参数磁共振参 数与组织Ki-67表达水平的关系。结果:Tn 2WI序列、动态增强扫描及扩散加权成像联合诊断阳性55例,阴性45例,联合检测对前列腺癌诊断的敏感度为92.00%(46/50),特异度为82.00% (41/50);与前列腺增生组相比,前列腺癌组患者表观扩散系数值(ADC)值、达峰时间(Tmax)显著下降[(0.67 ± 0.13) × 10n -3 mmn 2/s比(1.28 ± 0.17) × 10n -3 mmn 2/s、(17.43 ± 2.38) s比(22.37 ± 3.61) s],最大强化程度显著上升[(1.85 ± 0.21)%比(1.48 ± 0.17)%](n P < 0.05);Ki-67在前列腺癌患者中阳性指数显著高于前列腺增生患者[(68.15 ± 6.31)%比(12.64 ± 2.58)%, n P < 0.05];Ki-67阳性表达指数与ADC值呈负相关( n r = - 0.516,n P < 0.05),与最大强化程度呈正相关( n r = 0.426,n P < 0.05)。n 结论:多参数磁共振有助于区分前列腺癌和前列腺增生,对前列腺癌诊断的敏感度和特异度较高,其磁共振表现与Ki-67存在一定的相关性,可反映肿瘤细胞增殖活性。“,”Objective:To explore application of multi-parameters magnetic resonance imaging(MRI) in diagnosis of prostate cancer patients, and to analyze the relationship between various parameters and expression level of tissue Ki-67.Methods:One hundred patients suspected with prostate cancer who had underwent multi-parameters MRI before surgery from June 2018 to June 2019 in Qinhuangdao Second Hospital were enrolled. Taking preoperative needle biopsy pathology as golden standard, it was confirmed that there were 50 cases with prostate cancer and 50 cases with benign prostatic hyperplasia (BPH). Imaging features were compared between the two groups. The patients with prostate cancer underwent transrectal ultrasound guided perineal prostate biopsy. The expression of Ki-67 in prostate tissue was detected. The relationship between parameters of multi-parameters MRI and expression level of Ki-67 was analyzed.Results:The combination diagnosis of Tn 2WI sequence, dynamic contrast-enhanced scan and diffusion-weighted imaging showed that there were 55 positive cases and 45 negative cases. The sensitivity and specificity of combined detection for diagnosis of prostate cancer were 92.00% (46/50) and 82.00% (41/50) respectively. Compared with BPH group, ADC and Tmax level in prostate cancer group were significantly decreased: (0.67 ± 0.13) × 10n -3 mmn 2/s vs. (1.28 ± 0.17) × 10n -3 mmn 2/s, [(17.43 ± 2.38) s vs. (22.37 ± 3.61) s, while SImax level was significantly increased: (1.85 ± 0.21)% vs. (1.48 ± 0.17)%, n P<0.05. The positive index of Ki-67 in prostate cancer patients was significantly higher than that in BPH patients: (68.15 ± 6.31)% vs. (12.64 ± 2.58)%,n P<0.05. The positive expression index of Ki-67 was negatively correlated with ADC (n r=-0.516, n P<0.05), while positively correlated with maximum enhancement degree (n r=0.426, n P<0.05).n Conclusions:Multi-parameters MRI can help distinguish prostate cancer and BPH, which is of relatively higher sensitivity and specificity for diagnosis of prostate cancer. There is certain correlation between MRI findings and Ki67, which can reflect proliferation activity of tumor cells.
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