前列腺癌MRS与病理切片的对照研究

Study of the MRS of prostate cancer based on the pathologic sections

目的:将前列腺癌(Pca)术前磁共振波谱成像(MRS)结果与根治术后离体标本病理切片进行对照研究,探讨MRS诊断前列腺癌的可靠性。方法:根据5例行Pca根治术患者的术前MRS最大横径层面为兴趣层切取前列腺标本,依照MRS兴趣层内诸体素大小将标本层制备成与MRS结果一一对应的病理切片,以现行的CC/C([Cho+Cre)/Cit]值>0.86即为Pca的诊断标准确定MRS的有癌区及无癌区,对应分析病理结果后计算MRS诊断Pca的准确率、敏感度及特异度。结果:共得病理结果 90个,其中无癌区20个,有癌区70个。得到CC/C值90个,在CC/C值>0.86标准下,MRS诊断无癌区25个,有癌区65个,与病理对照诊断一致区域共73个,其中有癌区和无癌区分别为14个和59个,得到MRS诊断Pca的准确率=81.1%、敏感度=84.3%、特异度=70.0%。结论:该研究基于1H-MRS体素与病理切片的点对点对照分析的研究方法所得结果准确率相对可靠,为今后深入开展Pca MRS表现的病理学基础研究提供了一定参考。

Objective： To explore the MRS diagnostic reliability comparing to postoperative pathologie results. Methods： The prostate speeimens were spitted and layered according to the largest layer of MRS inspections before the radical prostateetomy in five patients. The prostate specimens were cut into pathologic sections in the light of MRS voxels. Defining the cancer voxels and the normal voxels according to the CC/C value above 0.86 corresponding to pathology. Results： There were 90 regions with valid pathologic diagnosis totally, 20 cancer-free and 70 cancer-affected. 25 cancer-free regions and 65 cancer-affected regions were identified as a criterion a CC/C value above 0.86 and was used for defining the cancer-affected region in MRS inspections and among which 59 and 14 regions were confirmed by pathologic diagnosis respectively. The accuracy was 81.1%, the sensitivity of 84.3% achieved with accompanying specificity of 70.0% as the CC/C value was 0.86. Conelusion： The method of comparing ~H-MRS voxels to postoperative pathology ensure the reliable result which may contribute to further researches of pathologic interpretation of the prostate 1H-MRS.