摘要
目的:探讨不同表观扩散系数(apparent diffusion coefficient,ADC),包括:瘤灶平均ADC值(Tumor-ADCmean值)、瘤灶最小ADC值(Tumor-ADCmin值)、瘤周ADC值(Peritum-ADC值)以及标准化ADC值(Peritum-ADC值/Tumor-ADCmin值,即ADC-normalized值)对早期宫颈癌淋巴管侵犯(lymphovascular invasion,LVI)的诊断价值。方法:回顾性分析我院81例早期宫颈癌患者的临床及磁共振征象,以病理结果为金标准,将患者分为LVI阳性以及LVI阴性组,比较两组Tumor-ADCmean值、Tumor-ADCmin值、Peritum-ADC值以及ADC-normalized值的差异性。计算不同ADC值对宫颈癌LVI的诊断效能。结果:81例早期宫颈癌患者中,LVI阳性26例、LVI阴性55例。两组患者年龄、组织类型差异没有统计学意义(均P>0.05);而肿瘤直径、肌层侵犯深度、FIGO分期、淋巴结转移差异有统计学意义(均P<0.05)。两组患者各ADC值的比较显示:Tumor-ADCmean值、Peritum-ADC值差异均无统计学意义(均P>0.05),而Tumor-ADCmin值、ADC-normalized值差异有统计学意义(均P<0.05);LVI阳性组Tumor-ADCmin值低于LVI阴性组(t=5.307,P<0.001),分别为[(0.76±0.15)×10-3mm2/s vs(0.97±0.18)×10 -3mm2/s];LVI阳性组ADC-normalized值高于LVI阴性组(t=-6.803,P<0.001),分别为[(2.02±0.29)vs(1.53±0.31)]。受试者工作曲线(receiver operating curve,ROC)显示:诊断早期宫颈癌LVI阳性时,ADC-normalized值的诊断效能优于Tumor-ADCmin值(Z=2.202,P=0.028),曲线下面积(area under curve,AUC)分别为:0.833 vs 0.922。结论:LVI阳性与早期宫颈癌多种恶性生物学行为有关,不同ADC值对早期宫颈癌LVI阳性具有较高的诊断价值,以ADC-normalized值的诊断效能最优。
Objective: To investigate the diagnostic value of different apparent diffusion coefficients(ADC), which include Tumor-ADCmean values, Tumor-ADCmin values, Peritumoral ADC(Peritum-ADC) values and ADC-normalized values(Peritum-ADC values/Tumor-ADCmin values),on lymphovascular invasion(LVI) in early cervical cancer. Methods: The clinical and magnetic resonance signs of 81 patients with early cervical cancer in our hospital were retrospectively analyzed. The pathological results were regarded as the gold standard. The patients were divided into two groups, the LVI positive group and the LVI negative group, according to pathological results. Differences in Tumor-ADCmean values, Tumor-ADCmin values, Peritum-ADC values and ADC-normalized values between the two groups were compared,and the diagnostic efficacy of different ADC values for LVI in cervical cancer was calculated. Results: Of 81 patients with early cervical cancer, 26 were LVI positive and 55 were LVI negative.There were no statistically significant differences in age and histological type between the two groups(P >0.05), but there were statistically significant differences in tumor diameter, depth of muscular invasion, International Federation of Gynecology and Obstetrics stage and lymph node status(P <0.05).There were no statistically significant differences in Tumor-ADCmean values and Peritum-ADC values between the two groups(P>0.05), but differences in Tumor-ADCmin values and ADC-normalized values were statistically significant(P <0.05).The Tumor-ADCmin value in the LVI positive group was lower than that in the LVI negative group [t=5.307, P<0.001,(0.76±0.15)×10-3mm2/s vs(0.97±0.18) ×10-3mm2/s, respectively]. The ADC-normalized values in the LVI positive group was higher than that in the LVI negative group [t=-6.803, P<0.001,(2.02±0.29) vs(1.53±0.31), respectively]. Receiver operating curve showed that the efficiency of ADC-normalized values was better than that of Tumor-ADCmin values(Z=2.202, P=0.028) in diagnosing LVI positive early cervical cancer
作者
徐晓曦
韩云
王鹏
张蔚
宋琼
Xu Xiaoxi;Han Yun;Wang Peng;Zhang Wei;Song Qiong(Department of Radiology,Wuhan N0. 1 Hospital,Wuhan Hospital of Traditional Chinese and Western Medicine,Wuhan 430022,Hubei,China;Department of Pharmacy,Ninth Hospital of Wuhan ,Wuhan 430081 ,Hubei,China)
出处
《肿瘤预防与治疗》
2019年第5期415-420,共6页
Journal of Cancer Control And Treatment
基金
湖北省卫生健康委员会科研项目(编号:WJ2019M026)~~
关键词
ADC值
早期宫颈癌
淋巴管侵犯
ADC values
Early cervical cancer
Lymphovascular invasion
