体素内不相干运动与直肠腺癌预后病理因素之间的相关性

Correlation Between Intravoxel Incoherent Motion and Prognostic Factors of Rectal Cancer

目的探讨体素内不相干运动(IVIM)的D、D*、f值与直肠腺癌病理预后因素之间的相关性。资料与方法回顾性分析2015年9月—2016年7月北京大学肿瘤医院未行新辅助治疗而直接手术的86例直肠腺癌患者的影像资料,包括直肠多b值扩散加权成像(DWI)检查,测量病灶相应的D、D*、f值。根据术后病理分化程度、T/N分期、脉管神经侵犯状态、表皮生长因子受体(EGFR)及人表皮生长因子受体-2(Her-2)表达水平进行分组,分析各定量参数与肿瘤病理学指标的关系。结果直肠腺癌不同分化程度(高、中、低)的D值分别为(0.541±0.093)×10^(-3) mm^2/s、(0.490±0.156)×10^(-3) mm^2/s、(0.342±0.147)×10^(-3) mm^2/s,差异有统计学意义(P<0.05);直肠腺癌脉管神经侵犯组D值为(0.511±0.154)×10^(-3) mm^2/s,未受侵犯组D值为(0.387±0.130)×10^(-3) mm^2/s,差异有统计学意义(P<0.05)。不同病理T、N分期肿瘤D、D*、f值差异无统计学意义(P>0.05)。EGFR及Her-2高表达组的f值均高于低表达组(0.379±0.076比0.298±0.099、0.356±0.097比0.298±0.098),差异有统计学意义(P<0.05)。结论直肠腺癌IVIM定量参数可望无创地评估肿瘤的生物学行为并预测患者的预后。

Purpose To explore the correlation between quantitative parameters from intravoxel incoherent motion（IVIM） with prognostic factors of rectal adenocarcinoma. Materials and Methods Eighty-six patients with rectal adenocarcinoma who were underwent surgery without neoadjuvant therapy in our hospital between September 2015 and July 2016 were selected in this retrospective study. The image data included multiple b-values diffusion weighted imaging（DWI） examination and the corresponding D, D＊ and f values of the lesions. Relationships between the quantitative parameters and tumor pathology indexes including histological differentiation grade, tumor T/N stage, lymphangiovascular invasion state, the expression level of epidermal growth factor receptor（EGFR） and human epidermal growth factor receptor-2（Her-2） were assessed. Results The average D values of different differentiation degree（high, middle and low） of rectal adenocarcinoma were（0.541±0.093）×10^-3 mm^2/s,（0.490±0.156）×10^-3 mm^2/s and（0.342±0.147）×10^-3 mm^2/s, and the difference was statistically significant（P〈0.05）. The D values were significantly different between the lymphangiovascular invasion and non invasion state [（0.511±0.154）× 10^-3 mm^2/s vs（0.387±0.130）×10^-3 mm^2/s, P〈0.05）]. However, there were no significant differences in the mean D, D＊ and f values among different tumor T/N stage（P〉0.05）. The average f value of EGFR or Her-2 high expression group was higher than that of low expression group（0.379±0.076 vs 0.298±0.099, P〈0.01; 0.356±0.097 vs 0.298±0.098, P〈0.05, respectively）.Conclusion Quantitative parameters of IVIM in rectal adenocarci-noma can be used as noninvasive imaging biomarkers to predict the biologic behavior of tumor and the prognosis of the patients.