基于DCE-MRI联合mDixon-Quant技术的瘤内与瘤周定量参数对直肠癌P53表达状态的研究

Intratumoral and Peritumoral Quantitative Parameters of DCE-MRI Combined with mDixon-Quant for Evaluating P53 Expression in Rectal Cancer

摘要: 目的：探讨动态对比增强磁共振成像(Dynamic Contrast-Enhanced Magnetic Resonance Imaging, DCE-MRI)联合魔镜成像技术(mDixon-Quant)获取的瘤内与瘤周定量参数，术前无创预测直肠癌P53表达状态的价值。材料和方法：回顾性分析73例经临床明确诊断的直肠癌患者资料，根据术后病理结果将患者分为P53突变组和P53野生组，所有患者均行DCE-MRI及mDixon-Quant检查，比较两组间各参数(K^trans, K_ep, V_e, R2^*, T2^*, FF)的差异，对差异具有统计学意义的参数进行单因素和多因素Logistic回归分析寻找P53表达状态的相关风险因素，绘制受试者工作特征(Receiver Operating Characteristic, ROC)曲线并计算曲线下面积(Area Under the Curve, AUC)评价预测效能。结果：P53突变组的瘤内K^trans、R2^*、FF和瘤周的K^trans、FF值高于P53野生组，而瘤周R2^*低于P53野生组，差异具有统计学意义(P < 0.05)。瘤内K^trans、R2^*和瘤周K^trans、R2^*、FF是P53表达状态的独立风险因素，瘤内K^trans + R2^*、瘤周K^trans + R2^* + FF、瘤内 + 瘤周联合参数评估直肠癌P53表达状态的效能分别为0.737、0.944、0.947。结论：DCE-MRI联合mDixon-Quant技术的瘤内与瘤周定量参数可有效反映直肠癌P53表达状态，联合多个参数可提高预测效能。

Abstract: Objective: To explore the value of quantitative parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with modified Dixon Quantification (mDixon-Quant) technology, both intratumoral and peritumoral, in preoperatively and non-invasively predicting P53 expression status in rectal cancer. Methods: A retrospective analysis was conducted on data from 73 patients with clinically confirmed rectal cancer. Based on postoperative pathological results, patients were categorized into the P53 mutant group and the P53 wild-type group. All patients underwent DCE-MRI and mDixon-Quant examinations. Differences in parameters (K^trans, K_ep, V_e, R2^*, T2^*, FF) between the two groups were compared. Univariate and multivariate logistic regression analyses were performed on parameters showing statistically significant differences to identify relevant risk factors associated with P53 expression status. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated to evaluate the predictive performance. Results: The intratumoral K^trans, R2^*, FF and peritumoral K^trans, FF values in the P53 mutant group were significantly higher than those in the P53 wild-type group, whereas the peritumoral R2^* was significantly lower than that in the P53 wild-type group, with statistically significant differences (P < 0.05). Intratumoral K^trans, R2^* and peritumoral K^trans, R2^*, FF were identified as independent risk factors for P53 expression status. The predictive performance of intratumoral K^trans + R2^*, peritumoral K^trans + R2^* + FF, and combined intratumoral + peritumoral parameters for assessing P53 expression status in rectal cancer was 0.737, 0.944, and 0.947, respectively. Conclusion: Quantitative parameters derived from both intratumoral and peritumoral regions using DCE-MRI combined with mDixon-Quant technology can effectively reflect the P53 expression status in rectal cancer, and the integration of multiple parameters enhances predictive performance.