前列腺癌扩散加权成像与Gleason评分的相关性研究

Correlation between diffusion-weighted MR imaging and Gleason score of prostate cancer

目的探讨前列腺癌肿瘤ADC值的变化与病理Gleason评分的关系。方法对经穿刺活检证实的65例前列腺癌患者行磁共振扩散加权成像检查,b值800s/mm2。根据病理结果将前列腺外周带六分区归类为癌区和非癌区,测量每个分区的ADC值,癌区与非癌区之间行ROC分析,并与病理Gleason评分进行对照。结果65例前列腺癌的癌区和非癌区ADC值分别为(1.19±0.30)×10-3mm2/s和(1.79±0.34)×10-3mm2/s,差异有统计学意义(t=17.74,P<0.01);ROC曲线上临界点取1.44×10-3m2/s,诊断的敏感性达84.30%,特异性为64.00%。癌区ADC值与Gleason评分呈负相关(r=-0.347,P<0.01)。结论前列腺癌癌区ADC值与Gleason评分呈负相关;ADC值有可能用于评价前列腺癌的分级和预后。

Objective To assess the correlation of the apparent diffusion coefficient （ADC） values with Gleason score in prostate cancer. Methods Diffusion-weighted MR imaging （DWI） was performed in 65 patients confirmed of prostate cancer with biopsy. Diffusion weighted images were obtained with b value of 800 s/mm^2. According to the pathological results, the peripheral prostate zone was divided into cancerous and noncancerous regions, and the ADC value of each region was measured and analyzed with ROC analysis. The correlation between the ADC value and Gleason score was analyzed. Results The mean ADC value of cancerous and noncancerous regions in 65 patients was （1.19 ±0.30） × 10^-3 mm^2/s and （1.79± 0. 34）× 10^-3 mm^2/s, respectively. There was statistical difference between cancerous and noncancerous regions （t= 17.74, P〈0.01）. With ROC cut point setting to 1.44 × 10^-3 mm^2/s, the diagnostic sensitivity and specificity for prostate cancer was 84.30% and 64.00%, respectively. The ADC values in cancerous regions were negatively correlated with Gleason score （r=-0. 347, P〈0. 01）. Conclusion The ADC values in cancerous regions are negatively correlated with Gleason score. ADC value might be useful to the evaluation of the grading and prognosis of prostate cancer.