目的 评价MRI征象结合血管内皮生长因子(VEGF)和增殖细胞核抗原( Ki-67)的表达在诊断子宫内膜癌及反映肿瘤分子生物学特性中的价值.资料与方法 回顾性分析经病理证实为子宫内膜癌的56例患者,术前1周行MRI扫描,以SP染色法检测56例子宫内膜癌石蜡切片中VEGF、Ki-67的表达情况,并以10例正常子宫内膜作为对照,评价MRI诊断子宫内膜癌的灵敏度,分析MRI分期与VEGF、Ki-67表达的相关性.结果 56例中MRI诊断为子宫内膜癌53例,诊断灵敏度为94.6％,其中Ⅰ期34例,诊断符合25例,诊断准确率为73.5％；Ⅱ期17例,诊断符合15例,诊断准确率为88.2％；Ⅲ期5例,诊断符合5例,诊断准确率为100％.VEGF表达指数:正常内膜2.75±1.04,Ⅰ期12.99±3.48,Ⅱ期20.12±5.08,Ⅲ期37.13±7.23;Ki-67的表达指数:正常内膜6.74±2.67, Ⅰ期18.32±5.28,Ⅱ期36.41±8.06,Ⅲ期48.75±9.04.VEGF、Ki-67的表达与MRI分期呈正相关(r=0.772、0.823,P= 0.001),表达指数随分期增加而增高.结论 MRI成像对子宫内膜癌术前分期具有较好的诊断价值,结合癌组织VEGF、Ki-67的表达,有利于临床治疗方案的选择.%Purpose To investigate the diagnostic value of MRI features combined with expression of Ki-67 and VEGF and to assess the molecule biology characteristics of endometrial tumor. Materials and Methods Preoperative MRI scan of 56 patients with pathology confirmed endometrial cancer were retrospective analyzed. The expression of Ki-67 and VEGF of 56 endometrial carcinomas was detrmined using immunohistochemistry sp method. Results 53 of 56 cases were diagnosed as endometrial carcinoma by MRI with sensitivity of 94.6%. The accuracy for stage I cancer was 73.5%, stage II 88.2%, stage ID 100%. VEGF expression index were: normal endometrium 2.75+1.04, Stage I: 12.99±3.48, stage II: 20.12+5.08, stage HI: 37.13+ 7.23. Ki-67 expression index were: normal endometrium 6.74±2.67; stage 1:18.32+5.28, stage II : 36.41+8.06, stage HI: 48.75 ±9.04. There was positive correlation between the expression of VEGF, Ki-67 and the stage on MRI. Correlation coefficients were 0.772 and 0.823 respectively (P = 0.001). Conclusion MRI is valuable to estimate preoperative staging of endometrial carcinoma. Combined with Ki-67 and VEGF expression, it helps determine clinical treatment plan.
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