不同级别肾透明细胞癌3.0T MR功能成像与E-cad的相关性研究  

Study on the invasive and prognostic value of 3. 0 T MR with Diffusion weighted imaging and E-cad in the cell grading of renal clear cell carcinoma

作　　者：陆蓉[1] 胥常云 周建军 金梅[1] 刘晓艳[1] 林璐 黄华[5] LU Rong;XU Changyun;ZHOU Jianjun;JIN Mei;LIU Xiaoyan;LIN Lu;HUANG Hua(Department of Radiology,Nantong University Affiliated Hospital,Jiangsu 226001,P.R.China;Department of Radiology,The Third People’s Hospital of Yancheng,Jiangsu 224001,P.R.China;Department of Radiology,Zhongshan Hospital,Fudan University,Shanghai 200032,P.R.China;Department of Radiology,The First People’s Hospital of Changzhou,Jiangsu 213000,P.R.China;Department of Pathology,Nantong University Affiliated Hospital,Jiangsu 226001,P.R.China)

机构地区：[1]南通大学附属医院影像科,江苏南通226001 [2]江苏省盐城市第三人民医院影像科,江苏盐城224001 [3]复旦大学附属中山医院放射科,上海200032 [4]江苏省常州市第一人民医院放射科,江苏常州213000 [5]南通大学附属医院病理科,江苏南通226001

出　　处：《医学影像学杂志》2018年第3期448-451,共4页Journal of Medical Imaging

基　　金：江苏省南通市科技局资助项目(编号:HS2014065);上海市自然科学基金资助项目(编号:14ZR1438400)

摘　　要：目的探讨不同级别肾透明细胞癌3.0T磁共振DWI和E-cad的相关性,探讨磁共振对肾癌侵袭性的评估价值。方法收集行肾脏磁共振检查并经临床、病理确诊的39例肾透明细胞癌。所有患者采用3.0T MR进行横断面DWI成像并行ADC值测量,采用Envasion法对肾透明细胞癌标本行免疫组化染色。结果 39例肾透明细胞癌平均ADC值=(1.6815±0.1769)×10^(-3)mm^2/s。10例高级别组肾透明细胞癌平均ADC值=(1.4990±0.0958)×10^(-3)mm^2/s,29例低级别组肾透明细胞癌平均ADC值=(1.7445±0.1533)×10^(-3)mm^2/s,行两独立样本非参数检验,两组间ADC值差异有统计学意义(z=-4.338,P=0.035)。肾透明细胞癌病理分级与E-cad表达呈负相关关系(r=-0.725,P=0.000),肾透明细胞癌ADC值与E-cad表达呈正相关关系(r=0.932,P=0.000)。结论透明细胞癌ADC值与E-cad表达呈正相关,ADC值有助于不同病理级别肾透明细胞癌的鉴别诊断,有助于判断预后、并指导穿刺活检、手术及治疗方案的确定。Objective To explore the invasive and prognostic value of diffusion weighted imaging at 3.0 T by analysing of the relationship between the expression of E-cad and the ADC value of the different grading of clear cell carcinoma.Methods The imaging and pathological data of 39 cases of clear cellrenal cell carcinoma underwent renal MRI,who were confirmed by clinical or pathological data.Cross sectional DWI imagings were carried on the patients by using GE Signa HD 3.0 T MR scanner.2 experienced radiologists measured the ADC values of these patients.Two senior pathologists assigned a immunohistochemical staining and calculate the positive cells.Results The mean ADC values of 39 clear cell renal cell carcinoma were(1.6815±0.1769)×10-3 mm 2/s.The mean ADC values of 10 high grade clear cell renal cell carcinoma group and 29 low grade group were(1.4990±0.0958)×10-3 mm 2/s,(1.7445±0.1533)×10-3 mm 2/s,respectively.The low grade group showed significant higher ADC value(z=-4.338,P=0.035).The grading of clear cell renal cell carcinoma had negative correlation with the expression of E-cad in clear cell renal cell carcinoma(r=-0.725,P=0.000).The ADC values of clear cell renal cell carcinoma had positive correlation with the expression of E-cad in clear cell renal cell carcinoma(r=0.932,P=0.000).Conclusion ADC values could help the differential diagnosis of different grading of clear cell renal cell carcinoma and provide instructive information for treatment programs.

关 键 词：肾透明细胞癌 磁共振成像 病理分级 E-钙粘蛋白 

分 类 号：R737.11[医药卫生—肿瘤] R441.2[医药卫生—临床医学]