前列腺良恶性疾病MR表观扩散系数与细胞增殖的相关性研究

Correlative Study of Diffusion Weighted Imaging and Proliferation in BPH and Prostate Cancer

目的通过表观扩散系数(ADC)与细胞密度、增殖细胞核抗原(PCNA)表达相关性分析,探讨扩散加权成像(DWI)评价良性前列腺增生(benign prostate hyperplasia,BPH)、前列腺癌(prostate cancer,PCa)细胞增殖状态的价值。资料与方法71例行DWI检查的前列腺疾病患者,其中PCa38例,BPH33例。根据常规HE染色和免疫组织化学记录PCa细胞密度及PCNA表达情况。对ADC值与细胞密度及PCNA表达水平进行相关性分析。结果PCa、BPH和正常外周带的平均ADC值分别为(49.32±12.68)×10-5mm2/s、(86.73±26.75)×10-5mm2/s和(126.25±27.21)×10-5mm2/s,差异有统计学意义(P<0.05)。PCa的细胞密度及PCNA表达平均值分别为12.9%和72.1%,高于BPH的细胞密度(8.6%)及PCNA表达(55.7%)(P<0.05)。PCa的ADC值与细胞密度及PCNA表达存在负相关性(r=-0.646、-0.446,P<0.05)。结论细胞密度是影响ADC值的重要因素,ADC值能对PCa细胞增殖状态进行评估。

Objective To study the relationship between ADC values and cellularity and PCNA in BPH and prostate cancer （PCa）. Materials and Methods The clinical and pathological data of 38 patients with PCa and 33 patients with BPH were studied. The MRI examination was performed on the supine position using 1.5T superconductive magnet scanner （Siemens Sonata） with a pelvic phased array multi coil. Diffusion weighted image （DWI） was acquired using EPI sequence. The ADC values of PCa, BPH and PZ were calculated. The cellularity was recorded according to hematoxylin and eosin （HE） staining. The PCNA was detected using immunohistochemical technique. Results The ADC values of PCa, BPH and PZ were （49.32 ± 12.68） ×10^-5 mm^2/s, （86.73 ± 26.75） × 10 ^-5 mm^2/s and （ 126.25 ± 27.21 ） × 10^ -5 mm^2/ s. The ADC values of PCa were lower than that of BPH and PZ （P 〈0.05）. The cellularity and PCNA of PCa were 12.9% and 72.1% respectively. The cellularity and PCNA of BPH were 8.6% and 55.7% respectively. ADC values were correlated negatively with the cellulariy and PCNA of prostate cancer （ r = - 0. 646, - 0. 446,P 〈 0.05 ）. Conclusion Cellularly is the most important factor to influent the ADC values of prostate cancer. ADC values can reflect the proliferation of prostate cancer.