磁共振定量参数对脑胶质瘤分级的诊断效能及与瘤组织EGFR Ki-67表达的关联性分析

doi:10.3969/j.issn.1006-6233.2021.06.033

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摘要 目的: 探究磁共振定量参数对脑胶质瘤分级的诊断效能及与瘤组织表皮生长因子受体(EGFR)、细胞核增殖相关抗原(Ki-67)表达的关联性。方法: 前瞻性选取2018年1月至2020年4月我院收治的87例脑胶质瘤患者,根据世界卫生组织中枢神经系统肿瘤分类分为低级别组(Ⅱ级,n=41)、高级别组(Ⅲ、Ⅳ级,n=46)。比较两组一般资料、磁共振定量参数[容积转运常数(K_trans)、血管外细胞外容积分数(V_e)、水肿宽度],采用受试者工作特征曲线(ROC)评价磁共振定量参数诊断脑胶质瘤分级的效能,并比较两组瘤组织EGFR、Ki-67阳性率和平均积分光密度,采用Pearson分析磁共振定量参数与瘤组织EGFR、Ki-67平均积分光密度的关系。结果: 高级别组K_trans、V_e、水肿宽度均高于低级别组(P<0.05);磁共振定量参数K_trans、V_e、水肿宽度联合诊断脑胶质瘤分级的曲线下面积(AUC)为0.891,大于各参数单一诊断,联合诊断的最佳敏感度、特异度分别为80.43%、87.80%;高级别组瘤组织EGFR阳性率、Ki-67阳性率及EGFR、Ki-67平均积分光密度均高于低级别组(P<0.05);K_trans、V_e、水肿宽度均与瘤组织EGFR、Ki-67平均积分光密度均呈正相关(P<0.05)。结论: 磁共振定量参数在脑胶质瘤分级诊断方面具有良好诊断效能,且与瘤组织EGFR、Ki-67表达呈正相关关系,早期明确磁共振定量参数变化情况可辅助临床判定脑胶质瘤分级诊断及EGFR、Ki-67表达情况。

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	陈雯
	李泽生
	钟凯

关键词 ：脑胶质瘤, 磁共振定量参数, 分级, 表皮生长因子受体, 细胞核增殖相关抗原, 诊断效能

Abstract：Objective: To explore the diagnostic efficacy of MRI quantitative parameters for the classification of glioma and its correlation with the expression of epidermal growth factor receptor (EGFR) and nuclear proliferation-related antigen (Ki-67) in tumor tissues. Methods: From January 2018 to April 2020, 87 patients with glioma admitted to our hospital were prospectively selected. According to the World Health Organization classification of tumors of the central nervous system, they were divided into low-grade group (grade Ⅱ, n=41) and high-grade group (grade Ⅲ, Ⅳ, n=46). The general data, quantitative parameters of magnetic resonance [volume transfer constant (K_trans), extravascular extracellular volume fraction (V_e), edema width] were compared between the two groups. The receiver operating characteristic curve (ROC) was used to evaluate the effectiveness of magnetic resonance quantitative parameters in the diagnosis of glioma grading, and the positive rates of EGFR and Ki-67 and the average integral optical density of the two groups were compared. Pearson was used to analyze the relationship between the quantitative parameters of magnetic resonance and the average integrated optical density of tumor tissue EGFR and Ki-67. Results: The K_trans, V_e and edema width of the high-grade group were higher than those of the low-grade group (P<0.05). The area under the curve (AUC) of MRI quantitative parameters K_trans, V_e, and edema width in the combined diagnosis of glioma classification was 0.891, which was greater than the single diagnosis of each parameter. The best sensitivity and specificity of combined diagnosis were 80.43% and 87.80%, respectively. The EGFR positive rate, Ki-67 positive rate and the average integrated optical density of EGFR and Ki-67 in the high-grade group were higher than those in the low-grade group (P<0.05). K_trans, V_e, and edema width were all positively correlated with the average integrated optical density of tumor tissue EGFR and Ki-67 (P<0.05). Conclusion: The quantitative parameters of magnetic resonance have good diagnostic performance in the grading diagnosis of glioma, and are positively correlated with the expression of EGFR and Ki-67 in tumor tissues. Early determination of the changes in the quantitative parameters of magnetic resonance can assist the clinical determination of the graded diagnosis of glioma and the expression of EGFR and Ki-67.

Key words： Glioma Quantitative parameters of magnetic resonance Grade Epidermal growth factor receptor Nuclear proliferation-associated antigen Diagnostic efficacy

基金资助:四川省卫生和计划生育科研课题资助项目,(编号:16ZD050)

引用本文:

陈雯, 李泽生, 钟凯. 磁共振定量参数对脑胶质瘤分级的诊断效能及与瘤组织EGFR Ki-67表达的关联性分析[J]. 河北医学, 2021, 27(6): 1035-1040.
CHEN Wen, LI Zesheng, ZHONG Kai. The Diagnostic Efficacy of MRI Quantitative Parameters in the Grading of Glioma and the Correlation Analysis with the Expression of EGFR and Ki-67 in Tumor Tissue. HeBei Med, 2021, 27(6): 1035-1040.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.06.033 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I6/1035

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