Correlation of quantitative parameters of dynamic enhanced magnetic resonance imaging with Dukes stage, lymph node metastasis and tumor differentiation degree of rectal cancer / 中国医师杂志

ABSTRACT

Objective@#To explore the correlation between quantitative parameters of dynamic enhanced magnetic resonance imaging (DCE-MRI) and Dukes stage, lymph node metastasis, tumor differentiation degree and molecular biological indicators [Ki67 and human epidermal growth factor receptor 2 (CerbB-2)] of rectal cancer.@*Methods@#This study was a prospective study. From October 2014 to October 2017, 168 cases of rectal cancer patients were selected as the research objects. DCE-MRI was performed preoperatively to obtain the quantitative parameter values of region of interest (ROI) [apparent diffusion coefficient (ADC)mean, Ktrans, Ve, and Kep] in tumor site. The expression of Ki67 and CerbB-2 were detected by immunohistochemical. Correlations of DCE-MRI quantitative parameter values and rectal cancer Dukes staging, lymph node metastasis, tumor differentiation degree to Ki67 and CerbB-2 expression level were analysised.@*Results@#With the increase of tumor differentiation, ADCmean was increasing, while Ktrans and Ve showed a downward trend, with significant difference (P<0.05). Among them, Ktrans and Ve in the high-differentiation group and the medium-differentiation group were significantly lower than those in the low-differentiation group (P<0.05), while there was no statistical significance between the high-differentiation group and the medium-differentiation group (P>0.05). The ADCmean was statistically significant between different groups (P<0.05), while Kep was not statistically significant (P>0.05). The ADCmean of lymph node metastasis group was significantly lower than that of no lymph node metastasis group (P<0.001), while Ktrans, Ve and Kep were significantly higher than that of no lymph node metastasis group (P<0.001). With the increase of Dukes staging in rectal cancer, ADCmean was decreasing and Ktrans was increasing, with statistically significant difference (P<0.001); among which the ADCmean of Dukes A and B was significantly higher than that of Dukes C and D (P<0.05), and Ktrans was significantly lower than that of Dukes C and D (P<0.05). Ktrans and Kep were increased with the increased expression levels of Ki67 and CerbB-2, and the difference between Ktrans and Kep was statistically significant (P<0.05). The ADCmean decreased with the increase of Ki67 and CerbB-2 expression level, and the difference was statistically significant (P<0.05).@*Conclusions@#DCE-MRI quantitatively participates can reflect the biological behavior of rectal cancer, and can be used to evaluate the prognosis of tumors and guide the clinical selection of more appropriate treatment options.