ADC值与老年宫颈癌病理分型及病理分级的相关性  

Correlation between ADC value of diffusion weighted MR imaging and pathological grading of elderly cervical cancer

作　　者：李健 潘志华 肖科 涂波 刘嘉 李虹成 肖维良 LI Jian;PAN Zhi-hua;XIAO Ke(Department of Radiology,416 Nuclear Industry Hospital,the Second Affiliated Hospital of Chengdu Medical College,Chengdu 610051,China)

机构地区：[1]成都医学院第二附属医院·核工业四一六医院放射科,成都610051

出　　处：《放射学实践》2022年第5期589-593,共5页Radiologic Practice

基　　金：四川省卫生和计划生育委员会科研课题(17PJ600)。

摘　　要：目的:探讨磁共振扩散加权成像(DWI)表观扩散系数(ADC)值与老年宫颈癌病理分型及病理分级的相关性及对宫颈癌的诊断价值。方法:回顾性分析2017年1月-2020年12月105例经病理检查证实的老年宫颈癌患者的临床及影像资料,术前均行T_(1)WI、T_(2)WI和DWI检查,测量肿瘤ADC值并分析其与病理分型及病理分级的相关性及对宫颈癌的诊断效能。结果:老年宫颈鳞癌患者的ADC值低于腺癌和腺鳞癌,差异均有统计学意义(P<0.05);随着分化程度增加,鳞癌ADC值呈明显上升趋势(P<0.05);多元线性回归分析结果显示,老年宫颈癌FIGO分期、病理类型和鳞癌分化程度均为影响ADC值的重要因素,回归方程为ADC值=0.591-2.167×(FIGO分期)+1.358×(病理类型)+4.076×(鳞癌分化程度);ROC曲线分析结果显示老年宫颈癌ADC值诊断鳞癌和低分化癌的曲线下面积(AUC)分别为0.824和0.915,敏感度分别为87.36%和91.89%,特异度分别为77.78%和76.47%。结论:老年宫颈癌中鳞癌的ADC值明显低于其他病理类型,且随着分化程度增加呈明显上升趋势,ADC值可为老年宫颈癌病理分级及分型判断提供参考信息。Objective:To explore the correlation between apparent diffusion coefficient(ADC)value of magnetic resonance diffusion weighted imaging(DWI)and patholoical classification and grading of elderly cervical cancer and its diagnostic efficacy for cervical cancer.Methods:The clinical data of 105 elderly patients with cervical cancer confirmed by cervical pathology between January 2017 and December 2020 were selected for retrospective analysis.All patients performed magnetic resonance imaging(MRI)including T_(1)WI,T_(2)WI and DWI,and ADC value of tumors was measured.The correlation between ADC value and pathological classification,grading,and its diagnostic efficacy were analyzed.Results:The ADC value of squamous cell carcinoma in elderly patients with cervical cancer was lower than that of adenocarcinoma and adenosquamous cell carcinoma,and the ADC value of squamous cell carcinoma showed a significant upward trend with the increase of differentiation degree(P<0.05).Linear regression analysis showed that the FIGO staging,pathological classification and grading of elderly cervical cancer and differentiation degree of squamous cell carcinoma were the independent factors affecting ADC value,and the regression equation was shown as ADC value=0.591-2.167×(FIGO staging)+1.358×(pathological classification)+4.076×(differentiation degree of squamous cell carcinoma).The ROC curve analysis showed that AUC of ADC in differentiating squamous cell carcinoma and poorly differentiated carcinoma were 0.824 and 0.915,the sensitivities were 87.36%and 91.89%,and the specificities were 77.78%and 76.47%,respectively.Conclusion:The ADC value of squamous cell carcinoma is significantly lower than that of other pathological types,and shows an obvious upward trend with the increase of differentiation degree.The ADC value can provide information for the pathological grading and classification of elderly cervical cancer.

关 键 词：宫颈癌 老年 病理分型 病理分级 磁共振成像 扩散加权成像 表观扩散系数 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]