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目的探讨子宫颈癌患者不同分化程度磁共振扩散加权成像(DWI)ADC值及r ADC值的变化及其与宫颈癌细胞增殖活性PCNA、Ki-67的相关性。方法经病理确诊为宫颈癌的患者40例,所有患者术前均行磁共振检查并进行扩散加权成像;术中病理均进行PCNA以及Ki-67免疫组化染色。应用方差分析分析不同分化程度宫颈癌患者PCNA以及Ki-67表达情况,Pearson相关分析法分析PCNA以及Ki-67、ADC与r ADC值的相关性。运用SPSS 20.0统计学软件对数据进行统计学分析,P<0.05为差异有统计学意义。结果低分化组ADC值以及r ADC值低于高分化组,差异有统计学意义(t=2.118,P<0.05)。低分化组与中分化组之间差异无统计学意义(P>0.05)。随着分化程度降低,PCNA以及Ki-67表达程度逐渐升高。随着PCNA以及Ki-67表达程度的升高,ADC值与r ADC值降低,差异均有统计学意义(P<0.05)。Pearson相关性检验后发现,ADC值与Ki-67和PCNA表达程度呈负相关(P<0.05)。结论宫颈癌DWI成像ADC、r ADC值的测量有助于评价并鉴别宫颈癌不同病理级别并有潜力作为评价肿瘤增殖程度的无创性方法。
Objective To investigate the changes of ADC value and r ADC value in patients with cervical cancer with different degree of differentiation by diffusion weighted imaging (DWI) and its correlation with proliferative activity of cervical cancer cells PCNA, Ki-67. Methods Forty patients with pathologically diagnosed cervical cancer were enrolled. All patients underwent preoperative magnetic resonance imaging and diffusion weighted imaging. PCNA and Ki-67 immunohistochemical staining were performed in all the cases. The ANOVAs were used to analyze the expression of PCNA and Ki-67 in different differentiated cervical cancer patients. Pearson correlation analysis was used to analyze the correlation between PCNA, Ki-67, ADC and r ADC. Using SPSS 20.0 statistical software for statistical analysis of data, P <0.05 for the difference was statistically significant. Results The ADC value and r ADC value of the poorly differentiated group were lower than that of the well-differentiated group (t = 2.118, P <0.05). There was no significant difference between poorly differentiated group and moderately differentiated group (P> 0.05). As the degree of differentiation decreased, the expression of PCNA and Ki-67 gradually increased. With the increase of PCNA and Ki-67 expression, ADC value and r ADC value decreased, the differences were statistically significant (P <0.05). Pearson correlation test found that ADC value was negatively correlated with the expression of Ki-67 and PCNA (P <0.05). Conclusion The measurement of ADC, r ADC in DWI imaging of cervical cancer is helpful to evaluate and identify different pathological grades of cervical cancer and has potential as a noninvasive method to evaluate the degree of tumor proliferation.