Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
World J Gastroenterol. 2024 Nov 28;30(44):4697-4708. doi: 10.3748/wjg.v30.i44.4697. Epub 2024 Dec 28.
Pancreatic ductal adenocarcinoma (PDAC) is a highly malignant and aggressive tumor, and high Ki-67 expression indicates poor histological differentiation and prognosis. Therefore, one of the challenges in diagnosing preoperatively patients with PDAC is predicting the degree of malignancy. Dynamic contrast-enhanced ultrasonography (DCE-US) plays a crucial role in abdominal tumor diagnosis, and can adequately show the microvascular composition within the tumors. However, the relationship between DCE-US and the Ki-67 labelling index remains unclear at the present time.
To predict the correlation between Ki-67 expression and the parameters of DCE-US.
Patients with PDAC who underwent DCE-US were retrospectively analyzed. Patients who had received any treatment (radiotherapy or chemotherapy) prior to DCE-US; had incomplete clinical, imaging, or pathologic information; and had poor-quality image analysis were excluded. Correlations between Ki-67 expression and the parameters of DCE-US in patients with PDAC were assessed using Spearman's rank correlation analysis. The diagnostic performances of these parameters in high Ki-67 expression group were evaluated according to receiver operating characteristic curve.
Based on the Ki-67 labelling index, 30 patients were divided into two groups, , the high expression group and the low expression group. Among the relative quantitative parameters between the two groups, relative half-decrease time (rHDT), relative peak enhancement, relative wash-in perfusion index and relative wash-in rate were significantly different between two groups ( = 0.018, = 0.025, = 0.028, = 0.035, respectively). The DCE-US parameter rHDT was moderately correlated with Ki-67 expression, and rHDT ≥ 1.07 was more helpful in accurately diagnosing high Ki-67 expression, exhibiting a sensitivity and specificity of 53.8% and 94.1%, respectively.
One parameter of DCE-US, rHDT, correlates with high Ki-67 expression. It demonstrates that parameters obtained noninvasively by DCE-US could better predict Ki-67 expression in PDAC preoperatively.
胰腺导管腺癌（PDAC）是一种高度恶性和侵袭性肿瘤，Ki-67 高表达表明组织学分化程度差且预后不良。因此，术前诊断 PDAC 患者的挑战之一是预测恶性程度。动态对比增强超声（DCE-US）在腹部肿瘤诊断中发挥着至关重要的作用，可充分显示肿瘤内的微血管组成。然而，目前 DCE-US 与 Ki-67 标记指数之间的关系尚不清楚。
预测 Ki-67 表达与 DCE-US 参数之间的相关性。
回顾性分析接受 DCE-US 的 PDAC 患者。排除在 DCE-US 之前接受任何治疗（放疗或化疗）、临床、影像或病理资料不完整以及图像分析质量差的患者。采用 Spearman 秩相关分析评估 PDAC 患者 Ki-67 表达与 DCE-US 参数之间的相关性。根据受试者工作特征曲线评估这些参数在高 Ki-67 表达组中的诊断性能。
根据 Ki-67 标记指数，将 30 例患者分为两组，即高表达组和低表达组。在两组之间的相对定量参数中，相对半减时间（rHDT）、相对峰值增强、相对灌注指数和相对灌注率差异有统计学意义（=0.018，=0.025，=0.028，=0.035）。DCE-US 参数 rHDT 与 Ki-67 表达呈中度相关，rHDT≥1.07 更有助于准确诊断高 Ki-67 表达，其灵敏度和特异性分别为 53.8%和 94.1%。
DCE-US 的一个参数 rHDT 与高 Ki-67 表达相关。这表明 DCE-US 获得的无创参数可以更好地预测 PDAC 患者术前的 Ki-67 表达。
