Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2024; 30(44): 4697-4708
Published online Nov 28, 2024. doi: 10.3748/wjg.v30.i44.4697
Correlation of dynamic contrast-enhanced ultrasonography and the Ki-67 labelling index in pancreatic ductal adenocarcinoma
Xiao-Jing Lin, Shu Zhu, Dan Wang, Jing-Yuan Chen, Su-Xian Wei, Shi-Yun Chen, Hong-Chang Luo
Xiao-Jing Lin, Shu Zhu, Dan Wang, Jing-Yuan Chen, Su-Xian Wei, Shi-Yun Chen, Hong-Chang Luo, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Author contributions: Lin XJ, Zhu S, Wang D, Chen JY, Wei SX, Chen SY and Luo HC designed the research study; Lin XJ, Zhu S, Wang D and Luo HC performed the research; Lin XJ, Chen JY, Wei SX and Chen SY analyzed the data; Lin XJ, Zhu S, Wang D, Chen JY and Luo HC wrote the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. TJ-IRB202402131.
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Chang Luo, PhD, Director, Doctor, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Qiaokou District, Wuhan 430030, Hubei Province, China. hongchangluo@qq.com
Received: May 20, 2024
Revised: September 22, 2024
Accepted: October 23, 2024
Published online: November 28, 2024
Processing time: 175 Days and 17 Hours
Abstract
BACKGROUND

Pancreatic ductal adenocarcinoma (PDAC) is a highly malignant and aggressive tumor, and high Ki-67 expression indicates poor histological differentiation and prognosis. Therefore, one of the challenges in diagnosing preoperatively patients with PDAC is predicting the degree of malignancy. Dynamic contrast-enhanced ultrasonography (DCE-US) plays a crucial role in abdominal tumor diagnosis, and can adequately show the microvascular composition within the tumors. However, the relationship between DCE-US and the Ki-67 labelling index remains unclear at the present time.

AIM

To predict the correlation between Ki-67 expression and the parameters of DCE-US.

METHODS

Patients with PDAC who underwent DCE-US were retrospectively analyzed. Patients who had received any treatment (radiotherapy or chemotherapy) prior to DCE-US; had incomplete clinical, imaging, or pathologic information; and had poor-quality image analysis were excluded. Correlations between Ki-67 expression and the parameters of DCE-US in patients with PDAC were assessed using Spearman’s rank correlation analysis. The diagnostic performances of these parameters in high Ki-67 expression group were evaluated according to receiver operating characteristic curve.

RESULTS

Based on the Ki-67 labelling index, 30 patients were divided into two groups, i.e., the high expression group and the low expression group. Among the relative quantitative parameters between the two groups, relative half-decrease time (rHDT), relative peak enhancement, relative wash-in perfusion index and relative wash-in rate were significantly different between two groups (P = 0.018, P = 0.025, P = 0.028, P = 0.035, respectively). The DCE-US parameter rHDT was moderately correlated with Ki-67 expression, and rHDT ≥ 1.07 was more helpful in accurately diagnosing high Ki-67 expression, exhibiting a sensitivity and specificity of 53.8% and 94.1%, respectively.

CONCLUSION

One parameter of DCE-US, rHDT, correlates with high Ki-67 expression. It demonstrates that parameters obtained noninvasively by DCE-US could better predict Ki-67 expression in PDAC preoperatively.

Keywords: Pancreatic ductal adenocarcinoma; Dynamic contrast-enhanced ultrasonography; Ki-67 antigen; Quantitative analysis; Prognostic situation

Core Tip: The Ki-67 labelling index reflects the proliferation of tumor cell and it can only be obtained using puncture biopsy or surgical resection. Pancreatic ductal adenocarcinoma (PDAC) is a highly malignant and aggressive tumor. Few studies on preoperative prediction of Ki-67 expression in PDAC using dynamic contrast-enhanced ultrasonography (DCE-US) have been conducted. Our results demonstrate that DCE-US helps noninvasively predict Ki-67 expression preoperatively in PDAC and it is valuable for surgeons to make clinical treatment program and assess prognosis.