磁共振扩散加权成像与直肠癌病理预后因素的相关性研究

Correlation Between Diffusion-Weighted Imaging of MR and Prognostic Factors of Rectal Cancer

目的探讨磁共振扩散加权成像ADC值与直肠癌病理预后因素的相关性。方法回顾性搜集45例经病理证实且未行辅助治疗而直接手术治疗的直肠癌患者的病理资料,并根据病理分化程度、T分期、N分期以及脉管、周围神经及直肠系膜筋膜受侵犯状态和免疫组织化学EGFR及P53表达情况进行分组。测量直肠癌的肿瘤组织b=800 s/mm2时的ADC值,分析各组之间肿瘤ADC值的相关关系。结果高、中、低分化组的ADC值依次降低,且差异具有统计学意义(P=0.016)。直肠癌N+组的ADC值低于N0组,差异具有统计学意义(P=0.037)。而不同病理T分期、脉管及周围神经受侵、直肠系膜筋膜受侵及癌结节不同分组间肿瘤平均ADC值的差异无统计学意义。EGFR、P3表达阳性组的平均ADC值均低于表达阴性组,但差异均无统计学意义(P>0.05)。结论直肠癌的ADC值与肿瘤的分化程度及淋巴结转移具有相关性,可有望通过ADC值的定量描述来评估肿瘤的生物学行为。

Objective To explore the correlation between value of apparent diffusion coefficient and prognostic factors of rectal cancer.Methods The DWI findings and pathology data of 45 patients with pathological proved rectal adenocarcinoma were retrospectively analyzed.They underwent primary staging MRI including DWI before surgery without neo-adjuvant therapy.The tumor ADC values were measured and compared with the histological and immunohistochemical characteristics.Results The ADC values were significantly different between the several groups of histological differentiation grades（P = 0.016）,and between N0 and N ＋（P = 0.037）.Tumor ADC values were significantly different when comparing groups stratified by T stage,mesorectal fascia status and presence of lymphangiovascular invasion.There were no significantly differences among the expression of EGFR and whether P3 was positive or negative（P 0.05）.Conclusion ADC values can reflect histological differentiation and lymph node metastasis of rectal cancer.ADC has the potential to become an imaging biomarker for assessing the biological features.