The Significance Of ADC Value And DCE-MRI Quantitative Parameters In Assess The Pathological Factorsand The Expressionof Ki67 In Endometrial Carcinoma

Objective:In thisstudy,we analyzed the relation of ADC values and DCE-MRI quantitative parameters(K^trans,K_ep,V_e)between different grades of endometrial cancer,different depths of myometrial invasion and different expression levels of Ki67 to explore its ability to predict the uterus Endometrial cancer pathological factors and ki67expression level,to determine whether it can guide the choice of clinical treatment options for endometrial cancer,predict the prognosis of endometrial cancer.Methods:Collected thecomplete information of 41 cases of endometrial cancer patients who is treated in our hospital from November 2015 to December 2017?All patients were underwent routine MRI examination and DWI and DCE-MRI scan in the week before surgery and confirmed by pathology.According to the 2009 FIIGO,the selected patients underwent surgical pathology grading and staging:15 patients with well-differentiated?G1?,20 patients with moderately differentiated?G2?,6 patients with poorly differentiated?G3?,25 patients with stage Ia,10 cases,3 patients with stage II,3patients with stage III.30 patients were further analyzed by immunohistochemistry.Results:There were 3 cases of Ki67?-?,2 cases of?+?,16 cases of?++?and 9 cases of?+++?,and the expression of Ki67 was?-?and?+?are grouped together.The statistical software SPSS21.0 was used to analyze the relation of ADC values and DCE-MRI quantitative parameters(K^trans,K_ep,V_e)between different grades of endometrial cancer,different depths of myometrial invasion and different expression levels of Ki67.Results:1,There was significant difference?P<0.05?in ADC value between different surgical pathological grades,and decreased with the increase of grade.Further comparison results showed that the difference between well-differentiated and moderately differentiated,well-differentiated and poorly differentiated There was statistical significance?P<0.05?,while there was no significant difference between moderately differentiated and poorly differentiated?P>0.05?.The moderately differentiated and poorly differentiated cases were combined into one group and analyzed with the ROC curve of well-differentiated ADC values,showing that the area under the curve of ADC value was 0.815.With an ADC cutoff of 0.795,the diagnostic sensitivity was 100%and the specificity was 60%.Spearman correlation analysis of further ADC value and pathological grade of endometrial carcinoma showed that there was a moderate negative correlation?P<0.05?between ADC value and pathological grade,and its r was-0.53.There were significant differences in K^transrans and V_e between different pathological grades?P<0.05?There were significant differences between K^trans,V_e in well-differentiated and poorly differentiated,moderately differentiated and poorly differentiated pairs,but no significant difference between well-differentiated and moderately differentiated.The well-differentiated and moderately differentiated cases were combined into one group and analyzed with the ROC curve of poorly differentiated K^trans,K_epp and V_e values,The results showed that K^transrans had the largest area under the corresponding curve and the highest diagnostic efficiency.When the K^transrans cutoff value was 0.44,the diagnostic sensitivity was 100%and the specificity was 74%.Further Spearman correlation analysis showed that there was a correlation between K^trans,K_epp and V_e and pathological grade of endometrial carcinoma?P<0.05?,and the correlation between K^transrans and pathological grade was the largest.The correlation between K^trans,K_epp and V_e and pathological grade of endometrial carcinoma was 0.486,0.392,0.342.2,With the increase of the depth of myometrial invasion,ADC value decreased gradually,K^trans,K_epp and V_e values gradually increased,and the difference of K^transrans was statistically significant?P<0.05?,while the values of ADC,K_ep,V_e There was no significant difference?P>0.05?.ROC curve analysis of different myometrial invasion depth showed that the area under the curve corresponding to K^transrans was 0.77.When the K^transrans cut offwas 0.385,the diagnostic sensitivity was 90%and the specificity was68%.3,With the increase of Ki67 expression,the ADC value showed a downward trend,K^trans,K_ep,V_e had an upward trend,but no statistical significance?P>0.05?.Spearman correlation analysis,the results showed that ADC,K^trans,K_ep,V_e and Ki67 expression levels were not related.Conclusion:The ADC value and quantitative parameter values have the ability to predict the surgical pathological grade of endometrial cancer and the depth of myometrial invasion?ADC value and quantitative parameter values do not have the ability to predict the expression level of Ki67 in endometrial carcinoma.DWI and DCE-MRI scan plays an important role in the diagnosis,treatment and prognosis of endometrial cancer.