MR波谱分析对前列腺癌Gleason评分的预估价值  

Value of MR spectrum in predicting the Gleason score of prostate cancer

作　　者：卢慧敏 夏春华 高斌 

机构地区：[1]安徽医科大学第三附属医院合肥市第一人民医院影像中心,安徽合肥230061

出　　处：《实用放射学杂志》2014年第2期263-266,共4页Journal of Practical Radiology

摘　　要：目的 初步探讨MRS检查的枸橼酸盐/（胆碱＋肌酸）[Cit/（Cho＋ Cr）,C/CC]值对前列腺癌Gleason评分的预估价值.方法 回顾性分析15例经超声引导下穿刺活检确诊为前列腺癌的患者,分别测得每例患者兴趣区的C/CC值,在超声引导下穿刺兴趣点,获得相应的Gleason评分,将C/CC值与穿刺病理的Gleason评分结果进行对照,通过绘制散点图及Spearman相关分析探讨二者的相关性,再根据C/CC值,对Gleason评分≥7组与Gleason评分＜7组进行独立样本t检验,P＜0.05为差异有统计学意义.将每一个C/CC值与对应的Gleason评分进行线性回归分析.结果 15例患者共测得75个兴趣区域的C/CC值,每例患者分别计算其平均C/CC值,经Spearman相关分析,C/CC值与对应区的Gleason评分呈负相关（r=-0.698,P=0.01）.Gleason评分＜7的高分化癌组的C/CC值平均为0.561±0.108,Gleason评分≥7的中低分化癌组的C/CC值平均为0.424±0.139,2组间差异有统计学意义（t=3.22,P=0.02）.经回归分析,每个Gleason评分与C/CC值存在一定的对应关系,方差分析结果（F=54.304,P=0.000）表明回归方程具有统计学意义,决定系数R2=0.459.结论 C/CC值与Gleason评分呈负相关,MRS可用于前列腺癌Gleason评分的预估.Objective To investigate the value of the ratio of Cit/（Cho＋Cr） with MRS in predicting the Gleason grading of prostatic cancer.Methods 15 patients with prostate cancer were analyzed retrospectively who were confirmed by puncturing biopsy under ultrasound guidance.The C/CC values of region of interest （ROI） in each patient were measured,and then the ROIs were punctured under the ultrasound guidance to get the corresponding Gleason score.The C/CC values and the corresponding Gleason score were compared,in which a scatter diagram and Spearman correlation analysis were used.The C/CC value in different groups with the Gleason score ≥7 or ＜7 was compared using independent samples t test.Linear regression analysis was analyzed with each C/CC value and corresponding Gleason score.Results A total of 75 ROIs with valid pathologic diagnosis were obtained.The average C/CC value was calculated in each patient.Spearman＇s rank correlation analysis revealed that the C/CC values of the prostatic carcinoma had a significant negative correlation with Gleason scores （r=-0.698,P=0.01）.The average C/CC ratio （0.561±0.108） in welldifferentiated carcinoma group （Gleason score ＜7） was more than that （0.424±0.139） in poorly differentiated one （Gleason score ≥ 7）,exhibiting a statistical difference （t=3.22,P=0.02）.The regression analysis showed there was a certain correspondence between each Gleason score and C/CC value.Analysis of variance results showed that the statistical significance of regression equation with a coefficient of determination R2=0.459 （F=54.304,P=0.000）.Conclusion C/CC values are negatively correlated with Gleason scores.MRS may be used to predict the Gleason scores of prostate cancer.

关 键 词：磁共振波谱分析 前列腺癌 GLEASON评分 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]