DCE-MRI定量参数与鼻腔鼻窦恶性肿瘤Ki-67标记指数的相关性及预测价值研究OA

Objective To investigate the correlation between quantitative parameters of dynamic contrast-enhanced MRI(DCE-MRI)and the Ki-67 labeling index(Ki-67 LI)in sinonasal malignant neoplasm(SNM),and to evaluate the value of DCE-MRI quantitative parameters in assessing the biological behavior of SNM.Methods A total of 86 patients with SNM confirmed by postoperative pathology were retrospectively collected.All patients underwent routine MRI and DCE-MRI before surgery.The Tofts two-compartment pharmacokinetic model was used to calculate DCE-MRI quantitative parameters,including volume transfer constant(Ktrans),rate constant(kep),and extracellular extravascular volume fraction(ve).Postoperative pathological specimens were analyzed using Ki-67 immunohistochemical staining.Using a cutoff value of 50%for Ki-67 LI,patients were divided into a low Ki-67 LI group(41 cases)and a high Ki-67 LI group(45 cases).According to different MRI scanners used,patients were divided into a training set(49 cases)and a validation set(37 cases).Comparisons between groups were performed using the t-test,Mann-Whitney U test,or chi-square test.Spearman correlation analysis was used to evaluate the correlation between DCE-MRI quantitative parameters and Ki-67 LI.Quantitative parameters with statistically significant differences between groups were included in multivariate logistic regression analysis to construct a predictive model for Ki-67 LI.Receiver operating characteristic(ROC)curves were used to evaluate the predictive performance of the model,and the area under the curve(AUC)was calculated.Results In both the training and validation sets,Ktrans and kep values in the high Ki-67 LI group were higher than those in the low Ki-67 LI group(all P<0.05),while there was no statistically significant difference in ve values between the two groups(both P>0.05).Ktrans and kep were positively correlated with Ki-67 LI(both P<0.05),whereas ve showed no correlation with Ki-67 LI(P>0.05).Multivariate logistic regression analysis demonstrated that Ktrans and kep were independent predictors of high Ki-67 LI in SNM,and a predictive model for Ki-67 LI was constructed based on these parameters.ROC curve analysis showed that the AUC of the predictive model in the training set was 0.735(95%CI:0.589-0.881),with a sensitivity of 75.0%and specificity of 71.4%;in the validation set,the AUC was 0.765(95%CI:0.607-0.922),with a sensitivity of 64.7%and specificity of 85.0%.The model demonstrated good performance(AUC>0.73 in both sets).Conclusion The predictive model based on DCE-MRI quantitative parameters Ktrans and kep can be used to evaluate the biological behavior of SNM.