摘要
目的采用酰胺质子转移加权成像分析宫颈癌的病理分化程度、分型及盆腔淋巴结转移(LNM)情况,评估酰胺质子转移加权成像在宫颈癌生物学行为中的应用价值。资料与方法回顾性收集2019年5月—2022年1月大连医科大学附属第一医院经术后病理证实的87例宫颈癌,其中宫颈鳞状细胞癌(CSC)64例、宫颈腺癌(CA)23例;将含有分化程度信息的50例CSC分为低分化组36例和高/中分化组14例,含有盆腔淋巴结信息的65例患者分为LNM组14例和无LNM组51例。2名观察者采用双盲法分别测量各组酰胺质子转移(APT)值,分析2名观察者测量结果的一致性,使用受试者工作特征曲线计算APT值评估CSC病理分级、CSC和CA鉴别及预测宫颈癌盆腔LNM的诊断效能。结果低分化组CSC的APT值高于高/中分化组,差异有统计学意义(Z=-2.940,P<0.05),APT值诊断CSC低分化的曲线下面积为0.770,阈值为2.33%,2名观察者测量结果的一致性很好(ICC=0.954、0.963);CSC组的APT值低于CA组,差异有统计学意义(t=-2.253,P<0.05),APT值诊断CA的曲线下面积为0.645,阈值为2.68%,2名观察者测量结果的一致性很好(ICC=0.961、0.869);LNM组的APT值高于无LNM组,差异有统计学意义(t=3.709,P<0.05),曲线下面积为0.795,阈值为2.88%,2名观察者测量结果的一致性很好(ICC=0.948、0.956)。结论酰胺质子转移加权成像能预测CSC的病理分级,区分CSC和CA,可有效预测宫颈癌盆腔LNM,对宫颈癌的生物学评估具有临床应用前景。
Purpose The degree of pathological differentiation,histological classification and lymph node metastasis(LNM)of cervical cancer are analyzed by amide proton transfer weighted imaging,which is used to evaluate the application value of amide proton transfer weighted imaging in the biological behavior of cervical cancer.Materials and Methods From May 2019 to January 2022,87 patients with cervical cancer confirmed by postoperative pathology were retrospectively collected,including 64 cases with cervical squamous cell carcinoma(CSC)and 23 cases with cervical adenocarcinoma(CA).A total of 50 CSC cases with information about pathological differentiation degree were divided into 36 cases with CSC poorly differentiated group and 14 cases with CSC well/moderately differentiated group.According to pathological results of lymph node-related information,65 patients with cervical cancer were divided into LNM(+)group(n=14)and LNM(-)group(n=51).Amide proton transfer(APT)values were measured by two observers and compared by double-blind method.Intra-class correlation coefficient(ICC)was used to analyze the consistency of APT values measured by two observers in each group.Receiver operating characteristic curve was used to calculate APT values,so as to evaluate the diagnostic efficacy of pathological grading of CSC,differentiating CSC from CA and predicting cervical LNM.Results The APT values of CSC in poorly differentiated group were significantly higher than that in well/moderately differentiated group,with statistically significant difference(Z=-2.940,P<0.05),and the measurement results of two observers were in good agreement(ICC=0.954,0.963).The area under the curve of CSC poorly differentiated group was 0.770,and the threshold were 2.33%.The APT values of CSC were significantly lower than that in CA group,with statistically significant difference(t=-2.253,P<0.05),the measurement results of two observers were in good agreement(ICC=0.961,0.869).The area under the curve of APT value in diagnosing CA was 0.645,and the threshold w
作者
孟醒
田士峰
马长军
林良杰
宋清伟
刘爱连
MENG Xing;TIAN Shifeng;MA Changjun;LIN Liangjie;SONG Qingwei;LIU Ailian(Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2024年第4期364-368,共5页
Chinese Journal of Medical Imaging
关键词
子宫颈肿瘤
淋巴转移
磁共振成像
酰胺质子转移加权成像
分化
病理学
外科
Uterine cervical neoplasms
Lymphatic metastasis
Magnetic resonance imaging
Amide proton transfer weighted imaging
Differentiation
Pathology,surgical
