表观扩散系数值在宫颈小细胞癌的病理诊断及预后预测中的应用  

The Application of Apparent Diffusion Coefficient Values in the Clinical Pathological Parameters and Prognostic Prediction of Cervical Small Cell Carcinoma

作　　者：姚琦敏 陈兴发[2] 陈建[2] YAO Qimin;CHEN Xingfa;CHEN Jian(Fujian JiangXia University;Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital,Fuzhou,Fujian 350000,China)

机构地区：[1]福建江夏学院 [2]福建医科大学附属福建省肿瘤医院,福建福州350000

出　　处：《九江学院学报(自然科学版)》2024年第4期85-91,共7页Journal of Jiujiang University:Natural Science Edition

基　　金：福建省中青年教师教育科研项目资助(编号JAT220238)的研究成果之一。

摘　　要：目的研究磁共振表观扩散系数值在宫颈小细胞癌病理诊断和预后预测中的应用。方法回顾性分析2002年11月至2020年7月在福建医科大学附属福建省肿瘤医院接受治疗的80例SCCC患者,所有患者在手术前均接受盆腔磁共振扫描,并测量肿瘤区域的ADC值(ADC_(max)、ADC_(mean)、ADC_(min))。采用t检验或Mann-Whitney U检验比较不同临床分组的ADC值差异。ROC曲线评估ADC值预测肿瘤分期及预后的检验效能。通过相关分析ADC值与临床病理参数之间的关系。使用Logistic回归分析预测宫颈小细胞癌术后复发的因素,并通过COX回归分析确定SCCC的独立预后因素。结果肿瘤晚期、肿瘤≥4cm、肿瘤浸润宫颈间质深层、Ki67>70%组的ADC值显著降低,差异具有统计学意义(p<0.05)。ADC_(max)、ADC_(mean)、ADC_(min)与FIGO分期、肿瘤大小、治疗后肿瘤进展之间存在显著负相关(p<0.05)。ROC曲线分析显示,ADC_(max)、ADC_(mean)、ADC_(min)预测肿瘤分期的曲线下面积(AUC)分别为0.653、0.704、0.712(p值均<0.05)。ADC_(max)、ADC_(mean)、ADC_(min)预测SCCC治疗后是否进展的AUC值分别为0.696、0.652、0.632(p值均<0.05)。此外,ADC_(max)、淋巴结转移是SCCC治疗后进展的独立危险因素,同时ADC_(min)、年龄<45岁和淋巴结转移是无进展生存的独立预后因素。结论ADC值作为一种非侵入性的影像学参数,不仅能预测在宫颈小细胞癌的临床病理因素,还可作为其独立预后因素,为临床决策和治疗计划的制定提供重要依据。Objective To investigate the application of magnetic resonance apparent diffusion coefficient(ADC)values in the pathological diagnosis and prognostic prediction of small cell carcinoma of the cervix(SCCC).Method A retrospective analysis was conducted on 80 patients with SCCC treated at Fujian Cancer Hospital affiliated with Fujian Medical University from November 2002 to July 2020.All patients underwent pelvic magnetic resonance imaging(MRI)prior to surgery and ADC values(ADC_(max)、ADC_(mean)、ADC_(min))were measured in the tumor regions.The t-test or Mann-Whitney U test was used to compare ADC values across different clinical groups.The efficacy of ADC values in predicting tumor stage and prognosis was assessed using ROC curve analysis.Correlations between ADC values and clinical pathological parameters were analyzed.Logistic regression was employed to identify factors predicting postoperative recurrence of SCCC,and COX regression analysis was used to determine independent prognostic factors for SCCC.Result ADC values were significantly lower in groups with advanced tumors,tumors≥4cm,tumors infiltrating deep cervical stroma,and Ki67>70%,with statistically significant differences(p<0.05).ADC_(max),ADC mea n and ADC_(min)were significantly negatively correlated with FIGO stage,tumor size,and post-treatment tumor progression(p<0.05).ROC curve analysis indicated that the area under the curve(AUC)for predicting tumor stage using ADC_(max)、ADC_(mean)、ADC_(min)were 0.653,0.704and 0.712,respectively(all p<0.05).The AUC values for predicting SCCC progression post-treatment were 0.696,0.652,and 0.632,respectively(all p<0.05).Furthermore,ADC_(max)and lymph node metastasis were identified as independent risk factors for post-treatment progression of SCCC,while ADC_(min),age<45 years,and lymph node metastasis were independent prognostic factors for progression-free survival.Conclusion As a non-invasive imaging parameter,ADC values not only predict clinical pathological factors in small cell carcinoma of the cervix b

关 键 词：宫颈小细胞癌 宫颈神经内分泌癌 磁共振 表观扩散系数 预后分析 

分 类 号：R737.3[医药卫生—肿瘤]