DCE-MRI药代动力学参数预估胰腺癌增殖及侵袭转移的可行性初探

目的探讨DCE-MRI药代动力学参数无创评估胰腺癌Ki67、MMP14表达状况,进而探讨其预估胰腺癌增殖及侵袭转移的可行性。方法前瞻性连续收集经病理证实的胰腺癌患者21例,术前行胰腺DCE-MRI扫描并测量癌灶的药代动力学参数Ktrans、Kep、Ve和Vp。采用独立样本T检验分别比较Ki67、MMP14高、低表达组,胰腺癌Ktrans、Kep、Ve和Vp的差异。采用ROC曲线评估DCE-MRI药代动力学参数预估胰腺癌Ki67、MMP14表达状况的效能。结果Ki67高表达组胰腺癌Ktrans、Kep分别高于低表达组(P=0.026,0.023)。MMP14高表达组胰腺癌Ktrans、Kep、Ve分别高于低表达组(P=0.004,0.012,0.002)。胰腺癌Ktrans、Kep评估Ki67高表达的AUC分别为0.791、0.777;胰腺癌Ktrans、Kep、Ve评估MMP14高表达的AUC分别为0.832、0.823、0.868。结论DCE-MRI药代动力学参数可无创评估胰腺癌Ki67、MMP14表达状况,有预估胰腺癌增殖及侵袭转移的潜能。

Preliminary study on the feasibility of DCE-MRI to predict proliferation,invasion and metastasis of pancreatic cancer

Objective To evaluate the expression of Ki67,MMP14 in pancreatic cancer by DCE-MRI pharmacokinetic parameters,and to explore the feasibility of prediction of proliferation,invasion and metastasis in pancreatic cancer.Methods 21 consecutive patients with confirmed pancreatic cancer were collected.Preoperative DCE-MRI was performed and the pharmacokinetic parameters(Ktrans,Kep,Ve and Vp)for each lesion were measured.Independent sample T test was used to compare the differences of Ktrans,Kep,Ve and Vp of pancreatic cancer between different Ki67 and MMP14 expression groups.ROC curVe was used to evaluate the diagnosis efficacy of pharmacokinetic parameters in predicting the expression of Ki67 and MMP14 of pancreatic cancer.Results Ktrans and Kep of Ki67 high expression group were all higher than that of low expression group(P=0.026,0.023).Ktrans,Kep and Ve of MMP14 high expression group were all higher than that of low expression group(P=0.004,0.012,0.002).AUC of Ktrans and Kep in diagnosis of pancreatic cancer with Ki67 high expression was 0.791 and 0.777,respectively.AUC of Ktrans,Kep and Ve in diagnosis of pancreatic cancer with MMP14 high expression was 0.832,0.823 and 0.868,respectively.Conclusion DCE-MRI pharmacokinetic parameters can noninvasively evaluate the expression of Ki67 and MMP14 in pancreatic cancer,which has the potential of predicting proliferation,invasion and metastasis in pancreatic cancer.