摘要
目的:探究乳腺癌磁共振成像体素内不相干运动-扩散加权成像(magnetic resonance imaging intravoxel incoherent motion-diffusion weighted imaging,MRI IVIM-DWI)参数与巨噬细胞炎性蛋白-1α(macrophage inflammatory protein-1α,MIP-1α)、血小板衍生生长因子(platelet-derived growth factor,PDGF)表达的相关性及其临床诊断价值。方法:前瞻性选取2018年7月至2019年10月某院收治的87例乳腺疾病患者作为研究对象,根据病理分析结果分为良性病变组(n=39例)和恶性肿瘤组(n=48例)。所有患者均行MRI IVIM-DWI检查,并进行免疫组化检测。MRI IVIM-DWI检查计算参数包括表观扩散系数(apparent diffusion coefficient,ADC)、单纯扩散系数D、伪扩散系数D*、灌注分数f;免疫组化检测病灶处MIP-1α、PDGF表达;采用Spearman分析MRI IVIM-DWI参数与MIP-1α、PDGF表达的相关性;绘制ROC曲线分析MRI IVIM-DWI参数对乳腺疾病良恶性的诊断价值。采用SPSS 25.0软件对数据进行处理。结果:与良性病变组相比,恶性肿瘤组MRI IVIM-DWI参数ADC、D值降低(P<0.05),D*、f值及MIP-1α、PDGF阳性率升高(P<0.05)。Spearman分析发现,MIP-1α、PDGF表达与MRI IVIM-DWI参数ADC、D值呈负相关(r=-0.428/-0.516、-0.369/-0.418,P<0.05),与D*、f值均呈正相关(r=0.518/0.433、0.476/0.458,P<0.05)。ROC曲线显示,MRI IVIM-DWI参数ADC、D、D*、f值预测乳腺疾病良恶性的AUC值分别为0.918、0.714、0.813、0.805,截断值分别为1.56×10^(-3)mm^(2)/s、1.24×10^(-3)mm^(2)/s、7.83×10^(-3)mm^(2)/s、7.72%,其敏感度分别为79.20%、93.80%、66.70%、75.00%,特异度分别为89.70%、43.60%、94.90%、84.60%;四者联合预测乳腺疾病良恶性的AUC值为0.964,敏感度为95.80%、特异度为87.20%。结论:乳腺癌MRI IVIM-DWI参数ADC、D、D*、f值与MIP-1α、PDGF表达相关性明显,且对乳腺肿瘤良恶性具有较高的诊断价值。
Objective To investigate the correlation between the magnetic resonance imaging intravoxel incoherent motion-diffusion weighted imaging(MRI IVIM-DWI)parameters and the expressions of macrophage inflammatory protein-1α(MIP-1α),platelet-derived growth factor(PDGF)of breast cancer patients and the clinical diagnostic value of MRI IVIM-DWI.Methods From July 2018 to October 201987 patients with breast diseases in some hospital were prospectively selected as the subjects and divided into a benign lesiongroup(n=39)and a malignant tumorgroup(n=48)according to the pathological analysis results.MRI IVIM-DWI and immunohistochemistry examinations were performed on all the patients.The following parameters were calculated during MRI IVIM-DWI examination:apparent diffusion coefficient(ADC),simple diffusion coefficient(D),pseudo-diffusion coefficient(D*)and perfusion fraction(f);during immunohistochemistry examination the expressions of MIP-1αand PDGF at the lesion were observed;the correlation between MRI IVIM-DWI parameters and MIP-1αand PDGF expressions was analyzed by Spearman;the diagnostic value of MRI IVIM-DWI parameters for benign and malignant breast diseases was explored by drawing receiver operating characteristic(ROC)curves.SPSS 25.0 software was used for data processing.Results Compared with the benign lesion group,the malignant tumor group had the ADC and D values decreased significantly(P<0.05),while the values of D*and f and the positive rates of MIP-1αand PDGF increased obviously(P<0.05).Spearman analysis found that the expressions of MIP-1αand PDGF negatively correlated with ADC and D values(r=-0.428/-0.516、-0.369/-0.418,P<0.05)while positively correlated with D*and f values(r=0.518/0.433、0.476/0.458,P<0.05).The ROC curves showed that the AUC values for the ADC,D,D*,and f values for predicting benign and malignant breast diseases were 0.918,0.714,0.813,and 0.805 respectively,with the cutoff values of 1.56×10^(-3)mm^(2)/s,1.24×10^(-3)mm^(2)/s,7.83×10^(-3)mm^(2)/s and 7.72%,the sensitivities of 79.20%,93.80%,66.70%and 75.00%and the specificities of 89.70%,43.60%,94.90%and 84.60%,respectively;comprehensive diagnosis by combining the ADC,D,D*,and f values had the AUC value being 0.964,the sensitivity being 95.80%and the specificity being 87.20%.Conclusion MRI IVIM-DWI parameters including ADC,D,D*and f values correlate significantly with MIP-1αand PDGF expressions in breast cancer patients,and have high diagnostic values for benign and malignant breast tumors.
作者
海江
张海莲
杨慧
巴正武
HAI Jiang;ZHANG Hai-lian;YANG Hui;BA Zheng wu(Department of Nuclear Magnetic Resonance,the Fifth People's Hospital of Qinghai Province,Xining 810007,China;Department of Medical Imaging,the Fifth People's Hospital of Qinghai Province,Xining 810007,China;Department of Gynecological Oncology,the Fifth People's Hospital of Qinghai Province,Xining 810007,China)
出处
《医疗卫生装备》
CAS
2022年第1期67-71,共5页
Chinese Medical Equipment Journal
