ADC值在胆囊癌病理学分级预测中的价值  

Value of ADC value in predicting histopathologic grade of gallbladder cancer

作　　者：贾迪[1] 胡翼江[1] 官忠燕[1] 徐正道[1] 王姣[1] 曹雷 陈建新[1] 沈钧康[2] JIA Di;HU Yi-jiang;GUAN Zhong-yan(Department of Radiology,Zhangjiagang First People's Hospital,Jiangsu 215600,China)

机构地区：[1]张家港市第一人民医院(苏州大学附属张家港医院)影像科,江苏215600 [2]苏州大学附属第二医院放射科,江苏215004

出　　处：《放射学实践》2023年第2期172-176,共5页Radiologic Practice

基　　金：张家港市科技支撑计划(社会发展)(ZKS1934)。

摘　　要：目的:探讨ADC值在胆囊癌病理学分级预测中的价值。方法:回顾性分析2014年1月至2019年12月因“胆囊占位”行胆囊切除术的43例胆囊癌患者的病例资料,其中Ⅰ级组14例,Ⅱ级组13例,Ⅲ级组16例,测量病灶ADC值并比较各组之间的差异,绘制受试者工作特征(ROC)曲线,确定鉴别诊断的最佳诊断阈值(cut-off值)。结果:Ⅰ级(高分化)胆囊癌组的平均ADC值[(1.58±0.25)×10^(-3)mm^(2)/s]高于II级(中分化)组[(1.25±0.21)×10^(-3)mm^(2)/s],差异具有统计学意义(P=0.001),当cut-off值取1.38×10^(-3)mm^(2)/s时,诊断敏感度、特异度、准确度分别为85.7%、92.3%、88.9%。Ⅱ级(中分化)组的平均ADC值[(1.25±0.21)×10^(-3)mm^(2)/s]高于Ⅲ级(低分化)组[(1.00±0.17)×10^(-3)mm^(2)/s],差异具有统计学意义(P=0.001),当cut-off值取1.135×10^(-3)mm^(2)/s时,诊断敏感度、特异度、准确度分别为76.9%、81.2%、82.8%。结论:ADC值在胆囊癌病理学分级的预测中具有一定价值。Objective:To evaluate the value of ADC values in predicting histopathologic grade of gallbladder cancer.Method:The clinical data of 43 patients with gallbladder adenocarcinoma who underwent cholecystectomy due to gallbladder mass from January 2014 to December 2019 were retrospectively analyzed.They were divided into grade Ⅰ group(n=14),grade Ⅱ group(n=12) and Grade Ⅲ group(n=16).ADC values were measured and compared among three groups.Receiver operating characteristic(ROC) curves were used to determine diagnostic performance.Results:Grade Ⅰ(well-differentiated) group showed higher ADC values than Grade Ⅱ(moderately-differentiated) group with significant difference [(1.58±0.25)×10^(-3)mm^(2)/s vs.(1.25±0.21)×10^(-3)mm^(2)/s,P=0.001].With the cut-off value of 1.38×10^(-3)mm^(2)/s,the diagnostic sensitivity,specificity and accuracy were 85.7%,92.3% and 88.9%,respectively.Grade Ⅱ(moderately-differentiated) group showed higher ADC values than Group Ⅲ(poorly-differentiated) group with significant difference [(1.25±0.21)×10^(-3)mm^(2)/s) vs.(1.00±0.17)×10^(-3)mm^(2)/s),P=0.001].With the cut-off value of 1.135×10^(-3)mm^(2)/s,the diagnostic sensitivity,specificity and accuracy were 76.9%,81.2% and 82.8%,respectively.Conclusion:The ADC value is helpful to predict the histopathologic grade of gallbladder carcinoma.

关 键 词：胆囊癌 ADC值 病理分级 扩散加权成像 磁共振成像 

分 类 号：R735.8[医药卫生—肿瘤] R445.2[医药卫生—临床医学]