基于ADC值变化量评估宫颈癌放化疗预后的价值  

Prognostic of Cer vical Cancer after Chemoradiotherapy Based on ADC Value Change

作　　者：张庆[1] 李云 熊浩[1] 彭婕[1] ZHANG Qing;LI Yun;XIONG Hao;PENG Jie(Jingzhou No 1 People's Hospital and First Affiliated Hospital of Yangtze University,Jingzhou 434000,Hubei Province,China)

机构地区：[1]长江大学附属第一医院荆州市第一人民医院放射影像科,湖北荆州434000

出　　处：《中国CT和MRI杂志》2023年第6期122-124,共3页Chinese Journal of CT and MRI

摘　　要：目的回顾性分析表观扩散系数(apparent diffusion coefficient,ADC)评估原发性宫颈癌同步放化疗(concurrent chemoradiotherapy,CC RT)预后的价值。方法COX回归分析肿瘤患者临床病理性质及不同A D C值与无病生存期(Disease-free survival,DFS)的关系,受试者工作特征曲线(receiver operator characteristic curve,ROC)确定危险因素的最佳截断值,比较不同危险因素下DFS的差异。结果单因素分析显示治疗前ADC值、△ADC%是肿瘤进展的危险因素(P=0.015,P=0.005),多因素分析显示只有△ADC%是肿瘤进展的高危因素(P=0.048),ROC曲线示最佳截断值为0.358(曲线下面积为0.847,敏感度为83.3%,特异度为75.9%),Kaplan-Meier曲线显示△ADC%<0.358的DFS显著低于>0.358的患者(P=0.012)。结论△ADC%可能是宫颈癌同步放化疗患者疾病进展与生存的有用预测指标。Objective To retrospectively analyze the value of apparent diffusion coefficient(ADC)in evaluating the prognosis of primary cervical cancer after concurrent chemoradiotherapy(CCRT).Methods Independent predictors were identified using cox regression analysis for clinicopathological factors and ADC values.Receiver operator characteristic curve(ROC)was used to determine the optimal cutoff value of risk factors.Disease-free survival(DFS)was compared by Kaplan-Meier analysis.Results Univariate analysis showed that preADC value and△ADC%were risk factors for tumor progression(P=0.015,P=0.005).Multivariate analysis showed that△ADC%was the only risk factor for tumor progression(P=0.048).ROC curve showed that the best cut-off value was 0.358(area under the curve was 0.847,sensitivity was 83.3%,specificity was 75.9%).Kaplan-meier curve showed that the DFS of patients with△ADC%<0.358 was significantly lower than that of patients with△ADC%>0.358(P=0.012).Conclusion The△ADC%is a potential predictive factor of disease progression or survival in patients with cervical cancer undergoing concurrent chemoradiotherapy。

关 键 词：宫颈癌 磁共振成像 表观弥散系数 预后 

分 类 号：R445.2[医药卫生—影像医学与核医学]