Rectal cancer: dynamic contrast-enhanced MRI correlates with lymph node status and epidermal growth factor receptor expression

J Magn Reson Imaging. 2014 Jun;39(6):1436-42. doi: 10.1002/jmri.24301. Epub 2013 Oct 11.

Abstract

Purpose: To evaluate correlations between dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and clinicopathologic data as well as immunostaining of the markers of angiogenesis epidermal growth factor receptor (EGFR) and CXC-motif chemokine receptor 4 (CXCR4) in patients with rectal cancer.

Materials and methods: Presurgical DCE-MRI was performed in 41 patients according to a standardized protocol. Two quantitative parameters (k21 , A) were derived from a pharmacokinetic two-compartment model, and one semiquantitative parameter (TTP) was assessed. Standardized surgery and histopathologic examinations were performed in all patients. Immunostaining for EGFR and CXCR4 was performed and evaluated with a standardized scoring system.

Results: DCE-MRI parameter A correlated significantly with the N category (P = 0.048) and k21 with the occurrence of synchronous and metachronous distant metastases (P = 0.029). A trend was shown toward a correlation between k21 and EGFR expression (P = 0.107). A significant correlation was found between DCE-MRI parameter TTP and the expression of EGFR (P = 0.044). DCE-MRI data did not correlate with CXCR4 expression.

Conclusion: DCE-MRI is a noninvasive method which can characterize microcirculation in rectal cancer and correlates with EGFR expression. Given the relationship between the dynamic parameters and the clinicopathologic data, DCE-MRI data may constitute a prognostic indicator for lymph node and distant metastases in patients with rectal cancer.

Keywords: CXCR4; DCE-MRI; EGFR; histopathology; immunohistochemistry; prognosis; rectal cancer; tumor microcirculation.

MeSH terms

  • Adenocarcinoma / blood supply
  • Adenocarcinoma / metabolism
  • Adenocarcinoma / pathology
  • Aged
  • Contrast Media*
  • ErbB Receptors / metabolism*
  • Female
  • Follow-Up Studies
  • Gadolinium DTPA
  • Humans
  • Image Enhancement / methods
  • Lymph Nodes / pathology*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Neovascularization, Pathologic / pathology
  • Observer Variation
  • Prognosis
  • Prospective Studies
  • Receptors, CXCR4 / metabolism
  • Rectal Neoplasms / blood supply
  • Rectal Neoplasms / metabolism*
  • Rectal Neoplasms / pathology*

Substances

  • CXCR4 protein, human
  • Contrast Media
  • Receptors, CXCR4
  • ErbB Receptors
  • Gadolinium DTPA