摘要
目的基于标化表观扩散系数(ADC)值预测膀胱癌患者人表皮生长因子受体2(HER2)的表达状态。方法回顾性研究127例膀胱尿路上皮癌患者的术前盆腔3.0T核磁共振(MRI)扫描图像,计算标化ADC值。采用免疫组织化学法(IHC)检测术后组织标本中的HER2表达状态。在HER2各表达水平间、不同表达状态划分间比较标化ADC值的差异。标化ADC值与HER2表达状态行相关性分析。受试者工作曲线(ROC)分析用于确定标化ADC值区分不同表达状态的最佳诊断阈值。结果标化ADC值与HER2表达水平呈负相关(tau-b=-0.180,P=0.008)。标化ADC值比较中,HER2过表达(IHC 2+、3+)低于HER2阴性(IHC 0、1+)(P=0.081),HER2表达(IHC 1+、2+、3+)显著低于HER2零表达(IHC 0)(P=0.020),HER2强阳性(IHC 3+)显著低于HER2非强阳性(IHC 0、1+、2+)(P=0.024)。标化ADC值区分HER2强阳性和非强阳性的最佳诊断阈值为0.849,敏感度0.621,特异度0.909,准确度0.765;区分HER2过表达和HER2阴性的最佳诊断阈值为0.909,敏感度0.547,特异度0.667,准确度0.607。结论病灶的标化ADC值与HER2表达水平呈负相关。标化ADC值是预测HER2表达水平的潜在工具。
Objective To predict the expression of human epidermal growth factor receptor 2(HER2)in urothelial bladder carcinoma based on normalized apparent diffusion coefficient(ADC).Methods The preoperative pelvic 3.0T magnetic resonance imaging(MRI)images of 127 patients with urothelial bladder carcinoma were retrospectively studied,the ADC was measured,and the HER2 expression in postoperative tissue specimens was determined with immunohistochemistry(IHC).The differences in normalized ADC were analyzed among different HER2 expressions and among different expression divisions.Correlation between normalized ADC and HER2 expression was analyzed.The optimal diagnostic threshold for distinguishing different expression divisions were determined with receiver operating characteristic(ROC)curve.Results Normalized ADC was negatively correlated with HER2 expression(tau-b=-0.180,P=0.008).Normalized ADC of HER2 overexpression group(IHC 2+,3+)was lower than that of HER2 negative group(IHC 0,1+)(P=0.081).Normalized ADC of HER2 expression group(IHC 1+,2+,3+)was significantly lower than that of HER2 zero-expression group(IHC 0)(P=0.020).Normalized ADC of HER2 strong positive group(IHC 3+)was significantly lower than that of HER2 non-strong positive group(IHC 0,1+,2+)(P=0.024).The optimal diagnostic threshold of HER2 strong positive group was 0.849;the sensitivity,specificity and accuracy were 0.621,0.909 and 0.765,respectively.The optimal diagnostic threshold of HER2 overexpression group was 0.909;the sensitivity,specificity and accuracy were 0.547,0.667 and 0.607,respectively.Conclusion Normalized ADC is negatively correlated with HER2 expression.ADC may be a potential marker for predicting HER2 expression.
作者
余瑞喜
蔡令凯
李凯
庄俊涛
吴启开
刘沛坤
曹强
李鹏超
杨潇
吕强
YU Ruixi;CAI Lingkai;LI Kai;ZHUANG Juntao;WU Qikai;LIU Peikun;CAO Qiang;LI Pengchao;YANG Xiao;LYU Qiang(Department of Urology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《现代泌尿外科杂志》
CAS
2023年第6期464-468,共5页
Journal of Modern Urology
基金
国家自然科学基金项目(No.82273152、82072832)
江苏省人民医院临床能力提升项目(No.JSPH-MC-2021-15)。
关键词
膀胱肿瘤
磁共振成像
表观扩散系数
ErbB受体
分子靶向治疗
bladder cancer
magnetic resonance imaging
apparent diffusion coefficient
ErbB receptors
molecular targeted therapy
