DWI-ADC值对晚期鼻咽癌诱导化疗疗效预测研究  

Value of apparent diffusion coefficient values in predicting induction chemotherapy response of advanced nasopharyngeal carcinoma

作　　者：郭炜[1] 罗德红[1] 林蒙[1] 李琳[1] 赵燕风[1] 杨亮[1] 周纯武[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院影像诊断科,北京100021

出　　处：《实用放射学杂志》2016年第3期350-353,共4页Journal of Practical Radiology

摘　　要：目的评估MR扩散加权成像表观扩散系数值（DWI-ADC值）对晚期鼻咽癌（NPC）诱导化疗疗效的预测价值。方法收集本院经病理证实的35例晚期NPC患者，放射治疗前均行正规2周期诱导化疗。于诱导化疗结束后依据肿瘤缓解情况分为完全缓解组（CR）、部分缓解组（PR）及稳定组（SD）。治疗有效组包括CR组及PR组。依据年龄分为20岁以下儿童青少年组与成人组。依据病理类型分为非角化未分化型癌组和非角化分化型癌组。依据国际抗癌联盟（UICC2010）T分期标准，分为T2、T3及T4组。对诱导化疗前各组间ADC值定量参数进行统计学分析。结果CR、PR、治疗有效组（CR＋PR）及SD组诱导化疗前肿瘤ADC值分别为（0.70±0．06）×10^-3mm^2／s、（0，72±0.04）×10^-3mm^2／s、（0．71±0．04）×10^-3mm^2／s及（0．85±0．02）±10^-3mm^2／s。PR组、治疗有效组AIX；值均低于SD组，且差异有统计学意义（P〈0.05）。20岁以下儿童-青少年组化疗前ADC值为（0.73±0．07）×10^-3mm^2／s，成人组化疗前ADC值为（0.75±0．07）×10^-3mm^2／s，二者化疗前ADC值差异无统计学意义。非角化未分化型癌组及非角化分化型癌组化疗前ADC值分别为（0.76±0．08）×10^-3mm^2／s、（0．74±0．06）×10^-3mm^2／s，二者化疗前ADC值差异无统计学意义。T2、T3、T4组化疗前ADC值分别为（0．78±0．05）×10^-3mm^2/s、（0．77±0．07）×10^-3mm^2／s及（0．75±0．08）×10^-3mm^2／s，各组化疗前ADC值差异虽无统计学意义，但随着T分期级别的增高，其ADC值有缓慢降低的趋势。结论诱导化疗前ADC值作为一个定量参数能够有助于预测NPC诱导化疗疗效。Objective To predict the response of induction chemotherapy in advanced nasopharyngeal carcinoma （NPC） by using pretreat ment apparent diffusion coefficient （ADC） values. Methods 35 patients with advanced NPC underwent DWI examination prior to 2-week induction chemotherapy. The patients were divided into CR （complete response） group,PR （partial response） one and SD （stable disease） one according to the tumor response of treatment. The effective responders included CR and PR groups. The patients were divided into children- adolescents（below 20 years）group and adults one according to the age,into non keratinizing undifferentiated carcinoma group and non keratinizing differentiated carcinoma one according to the pathological type, and also into T2, T3 and T4 groups according to the T-staging （UICC2010）. Statistical analysis was used to compare the pretreatment ADC values between different groups. Results The average pretreatment ADC values of CR,PR,responders and SD groups were （0.70±0.06）×10^-3mm^2/s,（0.72±0.04）×10^-3mm^2/s,（0.71±0.04）×10^-3mm^2/s and （0.85±0.02）×10^-3mm^2/s respectively. The average pretreatment ADC value of the SD group was signif- icantly higher than that of PR group and responders, and the differences were significant （P〈0.05）. The average pretreatment ADC value of children-adolescents and adults groups were （0.73±0.07）×10^-3mm^2/s and （0. 75±0.07）×10^-3mm^2/s,which showed no significant differences. The average pretreatment ADC value of non-keratinizing undifferentiated carcinoma and non-keratinizing differentiated carcinoma groups were （0.76±0.08）×10^-3mm^2/s and （0.74 ±0.06 ）×10^-3mm^2/s, which showed no significant differences. The average pretreatment ADC values of T2, T3 and T4 groups were （0.78±0.05）×10^-3mm^2/s, （0.77±0.07）×10^-3mm^2/s and （0.75±0.08）×10^-3mm^2/s. Although there were no significant differences between T2,T3 and T4 groups,a trend towards lower ADC was observed with increas

关 键 词：鼻咽癌 诱导化疗 表观扩散系数 

分 类 号：R739.63[医药卫生—肿瘤] R445.2[医药卫生—临床医学]