子宫内膜样腺癌表观扩散系数与免疫组化表达的相关性研究

Correlation between apparent diffusion coefficient and immunohistochemical expression in endometrioid adenocarcinoma

摘要:

目的： 探究基于直方图分析的子宫内膜样腺癌表观扩散系数（apparent diffusion coefficient，ADC）与雌激素受体（estrogen receptor，ER）、孕激素受体（progesterone receptor，PR）、抑癌基因P53及增殖抗原Ki67表达的相关性。方法： 分析68例术前行磁共振成像（magnetic resonance imaging，MRI）检查且术后病理证实为子宫内膜样腺癌患者的MRI及病理资料。对其免疫组化行半定量评分。利用相关软件在每个层面ADC图上勾画全肿瘤的感兴趣区（region of interest，ROI），不包括囊变、坏死、出血区域，并进行直方图分析得到ADC直方图参数，包括平均值、众数、峰度、偏度、最小值、最大值，以及第5、25、50、75、95百分位数。用Spearman相关分析对ADC直方图参数和免疫组化表达之间的相关性进行统计学分析。结果： ADC直方图参数中平均值、众数及第5、25、50、75、95百分位数与Ki67表达成负相关（相关系数及P值分别为r=-0.394，P=0.001；r=-0.373，P=0.002；r=-0.294，P=0.015；r=-0.359，P=0.003；r=-0.409，P=0.001；r=-0.371，P=0.002；r=-0.396，P=0.001）；众数及第5、25、50百分位数与P53表达成负相关（相关系数及P值分别为r=-0.307，P=0.011；r=-0.242，P=0.047；r=-0.252，P=0.038；r=-0.254，P=0.036），偏度与P53表达成正相关（r=0.345，P=0.004）；各直方图参数与ER、PR表达无明显相关性（P>0.05）。结论： ADC直方图参数与子宫内膜样腺癌P53、Ki67的表达有一定相关性，与子宫内膜样腺癌ER、PR的表达无明显相关性。术前的ADC值可以一定程度上间接反映临床病理特征，为临床个性化治疗提供更多信息。

Abstract:

Objective: To explore the correlation between the apparent diffusion coefficient (ADC) of endometrioid adenocarcinoma based on histogram analysis and the expression of estrogen receptor (ER), progesterone receptor (PR), tumor suppressor gene P53 and proliferating antigen Ki67. Methods: A total of 68 patients who underwent magnetic resonance imaging before surgery and whose pathology was confirmed to be endometrioid adenocarcinoma were analyzed. Semi-quantitative immunohistochemical scoring was performed. Relevant software was used to delineate the region of interest (ROI) of the whole tumor on the ADC map at each level, excluding cystic degeneration, necrosis, and bleeding areas. Histogram analysis was performed to obtain ADC histogram parameters, including mean, mode, kurtosis, skewness, minimum, maximum, 5th, 25th, 50th, 75th, and 95th percentiles. Spearman correlation analysis was used to statistically analyze the correlation between ADC histogram parameters and immunohistochemical expression. Results: The mean, mode, 5th, 25th, 50th, 75th and 95th percentiles of the ADC histogram parameters were negatively correlated with Ki67 expression (correlation coefficient and P value were r=-0.394, P=0.001; r=-0.373, P=0.002; r=-0.294, P=0.015; r=-0.359, P=0.003; r=-0.409, P=0.001; r=-0.371, P=0.002; r=-0.396, P=0.001, respectively); the mode, 5th, 25th and 50th percentiles were negatively correlated with P53 expression (correlation coefficient and P value were r=-0.307, P=0.011; r=-0.242, P=0.047; r=-0.252, P=0.038; r=-0.254, P=0.036, respectively), the skewness value was positively correlated with P53 expression (r=0.345, P=0.004). There was no significant correlation between the histogram parameters and the expression of ER and PR (P>0.05). Conclusion: ADC histogram parameters had a certain correlation with the expression of P53 and Ki67 in endometrioid adenocarcinoma, but had no obvious correlation with the expression of ER and PR in endometrioid adenocarcinoma. ADC values can indirectly reflect clinicopathological characteristics to a certain extent and provide more information for clinical personalized treatment.