扩散加权成像和临床分期在鼻咽癌预后评估中的价值  

The values of diffusion-weighted imaging and clinical staging in the prognostic evaluation of nasopharyngeal carcinoma

作　　者：芮银芳 周楠 杨阳[4] 周正扬[1] RUI Yinfang;ZHOU Nan;YANG Yang;ZHOU Zhengyang(Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University,Nanjing 210008,China;Department of Oncology,Nanjing Gaochun People’s Hospital/Gaochun Branch of Nanjing Drum Tower Hospital,Nanjing 211300,China;Department of Medical Imaging,Drum Tower Hospital,Nanjing University School of Medicine,Nanjing 210008,China;Department of Oncology,Drum Tower Hospital,Nanjing University School of Medicine,Nanjing 210008,China)

机构地区：[1]南京医科大学鼓楼临床医学院,江苏南京210008 [2]南京市高淳人民医院南京鼓楼医院高淳分院肿瘤科,江苏南京211300 [3]南京大学医学院附属鼓楼医院医学影像科,江苏南京210008 [4]南京大学医学院附属鼓楼医院肿瘤科,江苏南京210008

出　　处：《中国耳鼻咽喉颅底外科杂志》2022年第5期39-44,共6页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：国家自然科学基金资助项目(81871410)。

摘　　要：目的探讨扩散加权成像(DWI)测量的表观扩散系数值(ADC)和鼻咽癌2017分期在预后评估中的价值。方法回顾性分析90例鼻咽癌患者的临床和影像资料,评估原发肿瘤ADC值与鼻咽癌分期的相关性。治疗后进行随访,患者的中位随访时间为54个月(5~90个月),根据疾病进展情况分为疾病进展组(29例)和非进展组(61例),探讨影响鼻咽癌预后的因素。结果Ⅰ、Ⅱ期患者原发肿瘤ADC值显著高于Ⅲ期和Ⅳa期患者(P<0.05)。T1、T2期患者原发肿瘤ADC值显著高于T4期患者(P<0.05)。多因素分析显示,Ⅳa期较Ⅰ~Ⅲ期发生疾病进展的风险更大(OR=3.497,P=0.001)。结论鼻咽癌原发肿瘤ADC值与我国鼻咽癌2017分期相关。临床分期是鼻咽癌预后的预测因子。Objective To explore the values of the apparent diffusion coefficient(ADC)measured by diffusion-weighted imaging and the 2017 staging system of nasopharyngeal carcinoma in the prognostic evaluation.Methods Clinical and imaging data of 90 nasopharyngeal carcinoma patients were retrospectively analyzed.The correlation between ADC values of primary tumor and T stages,N stages and clinical stages were evaluated.The median follow-up time was 54 months(5 to 90 months).According to the disease progression after chemoradiotherapy,they were divided into progressive group(29 cases)and non-progressive group(61 cases).Results The ADC values of primary tumor ofⅠandⅡstages were significantly higher than those ofⅢand IVa stages(P<0.05).The ADC values of T1 and T2 stages were significantly higher than that of T4 stage(P<0.05).Multivariate analysis showed that the risk of disease progression inⅣa stage was higher than those in I toⅢstages(OR=3.497,P=0.001).Conclusions ADC value of primary tumor is correlated with 2017 staging system of nasopharyngeal carcinoma in China.Clinical stage is a prognostic factor for disease progression.

关 键 词：鼻咽癌 表观扩散系数 扩散加权成像 分期 预后 

分 类 号：R766.3[医药卫生—耳鼻咽喉科]