不同级别肾透明细胞癌3.0T MR功能成像与E-cad的相关性研究

Study on the invasive and prognostic value of 3. 0 T MR with Diffusion weighted imaging and E-cad in the cell grading of renal clear cell carcinoma

目的探讨不同级别肾透明细胞癌3.0T磁共振DWI和E-cad的相关性,探讨磁共振对肾癌侵袭性的评估价值。方法收集行肾脏磁共振检查并经临床、病理确诊的39例肾透明细胞癌。所有患者采用3.0T MR进行横断面DWI成像并行ADC值测量,采用Envasion法对肾透明细胞癌标本行免疫组化染色。结果 39例肾透明细胞癌平均ADC值=(1.6815±0.1769)×10^(-3)mm^2/s。10例高级别组肾透明细胞癌平均ADC值=(1.4990±0.0958)×10^(-3)mm^2/s,29例低级别组肾透明细胞癌平均ADC值=(1.7445±0.1533)×10^(-3)mm^2/s,行两独立样本非参数检验,两组间ADC值差异有统计学意义(z=-4.338,P=0.035)。肾透明细胞癌病理分级与E-cad表达呈负相关关系(r=-0.725,P=0.000),肾透明细胞癌ADC值与E-cad表达呈正相关关系(r=0.932,P=0.000)。结论透明细胞癌ADC值与E-cad表达呈正相关,ADC值有助于不同病理级别肾透明细胞癌的鉴别诊断,有助于判断预后、并指导穿刺活检、手术及治疗方案的确定。

Objective To explore the invasive and prognostic value of diffusion weighted imaging at 3.0 T by analysing of the relationship between the expression of E-cad and the ADC value of the different grading of clear cell carcinoma.Methods The imaging and pathological data of 39 cases of clear cellrenal cell carcinoma underwent renal MRI,who were confirmed by clinical or pathological data.Cross sectional DWI imagings were carried on the patients by using GE Signa HD 3.0 T MR scanner.2 experienced radiologists measured the ADC values of these patients.Two senior pathologists assigned a immunohistochemical staining and calculate the positive cells.Results The mean ADC values of 39 clear cell renal cell carcinoma were(1.6815±0.1769)×10-3 mm 2/s.The mean ADC values of 10 high grade clear cell renal cell carcinoma group and 29 low grade group were(1.4990±0.0958)×10-3 mm 2/s,(1.7445±0.1533)×10-3 mm 2/s,respectively.The low grade group showed significant higher ADC value(z=-4.338,P=0.035).The grading of clear cell renal cell carcinoma had negative correlation with the expression of E-cad in clear cell renal cell carcinoma(r=-0.725,P=0.000).The ADC values of clear cell renal cell carcinoma had positive correlation with the expression of E-cad in clear cell renal cell carcinoma(r=0.932,P=0.000).Conclusion ADC values could help the differential diagnosis of different grading of clear cell renal cell carcinoma and provide instructive information for treatment programs.