胰腺癌的ADC值和患者病理参数的关系研究

Study on the relationship between ADC value and pathological parameters in patients with pancreatic cancer

目的探讨胰腺癌高场磁共振扩散成像(DWI)表观扩散系数(ADC)值与纤维化含量、成纤维细胞活化蛋白(FAP)表达评分的相关性。方法对28例胰腺癌患者进行高场磁共振扩散加权成像扫面,每例患者取癌区与非癌区样本各一处,共取56处样本,使用单一层面发选取样本ROC并对ADC值进行测量。取28例患者经病理学检验证实的蜡块进行Masson染色,对FAP免疫组化染色,对ADC值与纤维化含量以及成纤维细胞活化蛋白表达评分之间的相关性进行Pearson相关分析。结果 ADC测量结果发现,患者胰腺癌区ADC值为(1.159±0.210)×10-3mm2/s,非胰腺癌区ADC值为(1.543±0.294)×10-3mm2/s,两项数据相比具有统计学差异。选取的28个癌区蜡块经病理学检验均为胰腺导管腺癌,检测其分化程度发现其中5例低分化,4例中-低分化,12例中分化,3例高-中分化,4例高分化,纤维化含量检测结果发现癌区纤维化含量最小值为20%,最大值为87%。FAP评分结果中12例5分,8例4分,3例3分,3例2分以及2例1分。相关性分析结果发现胰腺癌ADC值与纤维化含量之间呈负相关关系,但经统计学检验并未发现统计学意义,中-高分化的胰腺癌患者ADC与纤维化含量呈负相关关系,此数据具有统计学意义,而胰腺癌ADC值与成纤维细胞活化蛋白表达评分之间同样为负相关关系,P<0.05,数据具有统计学意义。结论胰腺癌高场磁共振扩散呈现表观扩散系数与纤维化含量以及成纤维细胞活化蛋白表达评分之间存在负相关关系,DWI可成为临床定量描述胰腺癌患者病理参数的有效工具。

Objective To investigate the correlation between the apparent diffusion coefficient （DWI） value of high field mag- netic resonance diffusion imaging （ADC） and the content of fibrosis and the expression of fibroblast activation protein （FAP） in pancreatic carcinoma. Methods 28 patients with pancreatic cancer, who were treated in our hospital from January 2013 to De- cember 2015, were selected. All patients were diagnosed as pancreatic cancer by routine MRI examination. 28 patierots with pan- creatic cancer underwent diffusion weighted magnetic resonance imaging scans, each patient from the cancer area and non cancer samples were seleete each one, with a total of 56 samples, a single level sample was used to measure the ADC value of ROC. 28 cases of patients with pathological examination confirmed that the paraffin blocks were stained with Masson, FAP immunohisto- chemical staining, the ADC value and the content of fibrosis and fibroblast activation protein Pearson expression score correlation between correlation were analyzed. Results ADC measurement results showed that the ADC value of patients with pancreatic cancer was （ 1. 159 ± 0. 210） ＊ ADC, l0^3 mm2/s value of non pancreatic cancer was （ 1. 543 ±0. 294） ＊ 10^3 mm2/s, two data were statistically different. 28 cancer paraffin blocks selected by pathological examination were pancreatic ductal adenocarcinoma, the degree of differentiation was found among the 5 cases of low differentiation, 4 cases of low differentiation, differentiation of the 12 cases, 3 cases of high differentiation, 4 cases of high differentiation, the results showed that the content of fibrosis in cancer minimal fibrosis the value was 20% , the maximum value was 87%. FAP score resuled in 5 cases of 12 points, 4 cases of 8 points, 3 cases of 3 points, 2 cases of 3 points and 1 case of 2 points. The correlation analysis showed that there was a negative correlation between ADC value and the content of pancreatic fibrosis, but did not find a statistically significant, in the high differ- entiated pancreatic cancer, ADC and fibrosis were negatively correlated, with statistical significance of the data, for the same neg- ative relationship was found between pancreatic cancer and fibroblast ADC, （ P 〈 0.05）. Data had statistical significance. Con- clusion Pancreatic cancer high field magnetic resonance diffusion shows that aoparent diffusion coefficient has fibrosis contentand a negative correlation between the expression of fibroblast activation protein score, DWI may become an effective tool to quan- titatively describe the clinical pathological parameters of pancreatic cancer patients.