Correlation Study Of DCE-MRI Quantitative Parameters With Expression Of MUC2 And Lymph Node Metastasis In Colorectal Cancer

Background Colorectal Cancer（CRC）is a common malignant tumor of the intestine,which threatens the health and quality of life of human beings with high morbidity and mortality worldwide.In China,the incidence rate is not only the first in the world,but also on the rise.The prognosis of patients with colorectal cancer is closely related to the degree of malignancy,metastasis and treatment,MUC2 has been shown to be a valuable biomarker in the diagnosis,immunotherapy and prognosis of colorectal cancer.Lymph node metastasis is one of the most common forms of metastasis in patients with colorectal cancer,but there is no accurate and non-invasive method to evaluate the status of lymph node metastasis before operation.Dynamic contrast enhanced magnetic resonance imaging（DCE-MRI）,which combines the magnetic resonance imagin and Hemodynamics features of tumors,has become the preferred imaging method for preoperative diagnosis of many tumors,DCE-MRI is not only valuable in the staging and re-staging of rectal cancer,but also useful in predicting the prognosis of rectal cancer.Objective The purpose of this study was to predict the expression of MUC2 and lymph node metastasis in colorectal cancer by analyzing the correlation between the quantitative parameters of DCE-MRI and the expression status of MUC2 and lymph node metastasis,it can provide more references for the individualized treatment,postoperative evaluation and long-term prognosis of colorectal cancer.Methods From December 2021 to November 2022,a total of 50 patients with primary colorectal cancer diagnosed by pathology and immunohistochemistry who underwent pelvic enhanced magnetic resonance examination in the People’s Hospital of China Three Gorges University were enrolled.According to the results of postoperative pathology and immunohistochemical staining,the patients were divided into MUC2 high expression group（26 cases）and MUC2 low expression group（24 cases）.There were 22 patients with lymph node metastasis and 28 patients without lymph node metastasis.All patients underwent pelvic enhanced MRI scan before surgery,and the scanning sequences were T2WI,DWI,and DCE-MRI.The general clinical data and imaging data of the patients were collected,and the quantitative parameters of DCE-MRI were measured by Gen IQ post-processing software:Volume transfer constant(K^trans),rate constant(K_ep)and extravascular and extracellular volume fraction（V_e）.SPSS 26.0 statistical software was used for data processing and statistical analysis.The qualitative data of the two groups were analyzed by chi-square test or Fisher exact test,and the quantitative data were analyzed by independent sample t test.When the data met the normality,the statistic was described as mean±standard deviation（x±s）,and the statistic was T value.Otherwise,Mann-Whitney U test was used with statistics described as median（25%,75%）and z-score as statistics.The receiver operating characteristic（ROC）curve was used to analyze the differential efficacy,sensitivity and specificity of DCE-MRI quantitative parameters.Spearman correlation analysis was used to evaluate the correlation between the quantitative parameters and MUC2 expression and lymph node metastasis.P<0.05 was considered statistically significant.Results（1）The K^transvalue（0.71（0.58,1.12）/min）and K_epvalue（1.92±0.69/min）of MUC2 high expression group were lower than those of MUC2 low expression group（1.01（0.72,1.32）/min）and（2.61（1.95,2.74）/min）.The difference between the two groups was statistically significant（P=0.013,0.009,P<0.05）.There was no significant difference in V_evalues between the two groups（0.36（0.31,0.49）,0.50（0.37,0.52）,P=0.239,P>0.05）.（2）The expression of MUC2 was negatively correlated with K^transvalue（r=-0.605,P=0.023,P<0.05）.The expression of MUC2 was negatively correlated with K_epvalue（r=-0.566,P=0.019,P<0.05）.There was no correlation between MUC2 expression and V_evalue（r=0.270,P=0.249,P>0.05）.（3）When K_epwas set at 1.903/min,the area under the ROC curve of DCE-MRI was the largest,and the sensitivity of diagnosis was the highest（AUC=0.828,sensitivity 100%,specificity 54.5%）.When K^transwas set at 0.817/min,the area under the ROC curve was the largest.The diagnostic sensitivity was the highest（AUC=0.687,sensitivity 81.7%,specificity 77.8%）.（4）There was no significant correlation between lymph node metastasis and K^trans,K_ep,V_evalues（P>0.05）,and there was no significant difference in DCE-MRI quantitative parameter values between the two groups（P>0.05）.Conclusion 1.There is a certain correlation between the quantitative parameters of DCE-MRI and the expression of MUC2,that is,the higher the K^transand K_ep,the lower the expression of MUC2,suggesting that the quantitative parameters of K^transand K_epcan predict the expression of MUC2 in patients with colorectal cancer before surgery,and K_ephas a better predictive value.2.Other factors need to be considered in the preoperative prediction of lymph node metastasis with DCE-MRI quantitative parameters,and lymph node status can not be accurately assessed simply by measuring the quantitative parameters of the tumor.