指数化表观扩散系数值在预测FIGOⅠ/Ⅱ期宫颈癌患者无进展生存期中的价值  

The value of exponential apparent diffusion coefficient value in predicting progression-free survival in patients with FIGO stageⅠ/Ⅱcervical cancer

作　　者：任婉旭 邓蕾 尚阿利 车志文 仲津漫 杨全新 REN Wanxu;DENG Lei;SHANG Ali;CHE Zhiwen;ZHONG Jinman;YANG Quanxin(School of Medical Technology,Shaanzi University of Traditional Chinese Medicine,Xianyang,Shaanri Province 712046,China;Department of Imaging,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]陕西中医药大学医学技术学院,陕西咸阳712046 [2]西安交通大学第二附属医院影像科,陕西西安710004

出　　处：《实用放射学杂志》2024年第3期402-405,421,共5页Journal of Practical Radiology

基　　金：陕西省自然科学基金项目(2022JQ-939);陕西省重点研发计划一般项目(2021SF-267)。

摘　　要：目的探讨国际妇产科联盟(FIGO)Ⅰ/Ⅱ期宫颈癌患者根治性子宫切除术前的指数化表观扩散系数(eADC)值与术后临床结果的相关性,寻找预测早期宫颈癌患者预后的MR定量指标.方法回顾性选取行手术治疗的FIGOⅠ/Ⅱ期宫颈癌患者,所有患者均于术前进行MRI平扫及扩散加权成像(DWI)扫描.基线参数包括:年龄、绝经与否、分期、肿瘤大小、病理分化及类型、淋巴结受累和术后辅助治疗.MR参数:平均ADC(ADCmean)、标准化ADC(nADC)、eADC、DWI信号强度(SIDWI)、T2WI信号强度(SIT2).通过Cox回归分析与复发相关的基线和MRI参数.结果低eADC组的无进展生存期(PFS)长于高eADC组(P=0.010).单因素分析显示,ADC、nADC和eADC与复发相关(P<0.05).多因素分析发现,仅有eADC[危险比(HR)3.610;95%置信区间(CI)1.467~8.886;P=0.005]与复发相关.结论术前eADC与经手术治疗的FIGOⅠ/Ⅱ期宫颈癌患者的PFS有关,有助于评估宫颈癌患者的预后.Objective To explore the correlation between exponential apparent diffusion coefficient(eADC)value before radical hysterectomy and postoperative clinical results in patients with International Federation of Gynecology and Obstetrics(FIGO)stageⅠ/Ⅱcervical cancer,and to find MR quantitative indicators for predicting the prognosis of patients with early stage cervical cancer.Methods Patients with FIGO stageⅠ/Ⅱcervical cancer who underwent surgical treatment were retrospectively collected.All patients underwent MRI plain scan and diffusion weighted imaging(DWI)scan before surgery.Baseline parameters included age,menopause,stage,tumor size,pathological differentiation and type,lymph node involvement,and postoperative adjuvant therapy.MR parameters included mean apparent diffusion coefficient(ADCmean),normalized apparent diffusion coefficient(nADC),eADC,SIDWI,and SIT2.Baseline and MRI parameters associated with recurrence were determined by Cox regression analysis.Results The progression-free survival(PFS)in the low eADC group was longer than that in the high eADC group(P=0.010).Univariate analysis showed that ADC,nADC and eADC were associated with recurrence(P<0.05).In multivariate analysis,only eADC[hazard ratio(HR)3.610;95%confidence interval(CI)1.467-8.886;P=0.005]was associated with recurrence.Conclusion Preoperative eADC is associated with PFS in patients with surgically treated FIGO stageⅠ/Ⅱcervical cancer and is helpful in evaluating the prognosis of patients with cervical cancer.

关 键 词：宫颈癌 无进展生存期 复发 扩散加权成像 

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