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• Clinical Articles •
The value of the apparent diffusion coefficient in preoperative prediction of myometrial infiltration, Ki-67 and P53 expression levels in endometrial carcinoma
ZHANG Meng  JING Mengyuan  CAO Yuntai  GUO Yuzhen 

Cite this article as: ZHANG M, JING M Y, CAO Y T, et al. The value of the apparent diffusion coefficient in preoperative prediction of myometrial infiltration, Ki-67 and P53 expression levels in endometrial carcinoma[J]. Chin J Magn Reson Imaging, 2023, 14(7): 78-85. DOI:10.12015/issn.1674-8034.2023.07.014.


[Abstract] Objective To investigate the feasibility of the apparent diffusion coefficient (ADC) in the preoperative noninvasive prediction of myometrial infiltration, Ki-67 and P53 expression levels in patients with endometrial cancer (EC).Materials and Methods Retrospective analysis of 105 patients with EC who underwent preoperative MRI diffusion weighted imaging (DWI) and were confirmed by pathology after operation from January 2017 to December 2021 in the Second Hospital of Lanzhou University. Two independent radiologists measured the ADC value (ADCmax, ADCmean and ADCmin) of EC on the ADC image by comparing MRI enhancement and DWI images respectively. Statistical methods were used to calculate the correlation between clinical information, ADC values and myometrial infiltration, Ki-67 and P53 expression in EC patients. A nomogram prediction model was constructed and the constructed prediction model was evaluated by plotting the receiver operating characteristic (ROC) curve, calibration curve analysis and decision curve analysis (DCA).Results ADCmax, ADCmean and ADCmin were significantly correlated with myometrial infiltration, Ki-67 and P53 expression levels in EC patients (P＜0.05). The International Federation of Gynecology and Obstetrics (FIGO) stage was only significantly associated with myometrial infiltration and Ki-67 expression levels in EC patients (P＜0.05). The ADCmax, ADCmean and ADCmin were combined with FIGO stage to construct the nomogram model. The nomogram model, ADCmax, ADCmean, ADCmin and FIGO stage predicted area under the curve (AUC) values of 0.809, 0.707, 0.693, 0.694 and 0.599 for myometrial infiltration, respectively. The AUC values for predicting Ki-67 expression levels were 0.897, 0.879, 0.849, 0.808 and 0.550, respectively. The nomogram model was constructed by combining ADCmax, ADCmean and ADCmin. The AUC values predicted P53 expression levels by the nomogram, ADCmax, ADCmean and ADCmin were 0.665, 0.615, 0.641 and 0.654, respectively.Conclusions The nomogram prediction model based on ADC values combined with FIGO stage can be used as a useful method for the preoperative non-invasive assessment of myometrial infiltration, Ki-67 and P53 expression in EC patients.
[Keywords] endometrial carcinoma；myometrial infiltration；Ki-67；P53；magnetic resonance imaging；apparent diffusion coefficient

ZHANG Meng1   JING Mengyuan2   CAO Yuntai3   GUO Yuzhen1*  

1 Department of Gynecology, Second Hospital of Lanzhou University, Lanzhou 730030, China

2 Department of Radiology, Second Hospital of Lanzhou University, Lanzhou 730030, China

3 Department of Radiology, Affiliated Hospital of Qinghai University, Xining 810000, China

Corresponding author: Guo YZ, E-mail: guoyz@lzu.edu.cn

Conflicts of interest   None.

Received  2023-01-04
Accepted  2023-06-28
DOI: 10.12015/issn.1674-8034.2023.07.014
Cite this article as: ZHANG M, JING M Y, CAO Y T, et al. The value of the apparent diffusion coefficient in preoperative prediction of myometrial infiltration, Ki-67 and P53 expression levels in endometrial carcinoma[J]. Chin J Magn Reson Imaging, 2023, 14(7): 78-85. DOI:10.12015/issn.1674-8034.2023.07.014.

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