结直肠癌患者MSCT灌注参数、MR-DWI表观扩散系数与TNM分期的相关性

Correlation between MSCT parameters,apparent diffusion coefficient of MR-DWI and TNM staging in patients with colorectal cancer

目的研究结直肠癌患者多层螺旋CT(MSCT)灌注参数、磁共振弥散加权成像(MR-DWI)表观扩散系数(ADC)与TNM分期的相关性。方法抽取2020年3月至2021年9月晋中市第二人民医院收治的68例经病理学证实为结直肠癌的患者为研究对象,依据病理结果进行TNM分期,比较不同TNM分期患者MSCT灌注参数[血容量(BV)、血流量(BF)、达峰时间(TTP)、表面通透性(PS)]和MR-DWI的ADC值差异,采用Spearman相关分析MSCT灌注参数、MR-DWI的ADC值与TNM分期的相关性。结果病理结果显示,T分期中,T1期15例,T2期10例,T3期30例,T4期13例;N分期中,N0期20例,N1期29例,N2期19例;M分期中,M0期30例,M1期38例。T分期中,T3~T4期患者BF低于T1~T2期患者,TTP、PS高于T1~T2期患者(P<0.05);N分期中,N1~N2期患者BF低于N0期患者,TTP、PS高于N0期患者(P<0.05);M分期中,M1期患者BF低于M0期患者,TTP、PS高于M0期患者(P<0.05);BV在TNM分期中比较差异未见统计学意义(P>0.05)。Spearman相关性分析结果显示,BF与TNM分期呈负相关性(r=-0.632,P<0.05),TTP、PS与TNM分期呈正相关性(r=0.659、0.654,P<0.05),BV与TNM分期无相关性(r=0.206,P>0.05)。T分期中,T3~T4期患者ADC值低于T1~T2期患者(P<0.05);N分期中,N1~N2期患者ADC值低于N0期患者(P<0.05);M分期中,M1期患者ADC值低于M0期患者(P<0.05)。Spearman相关性分析结果显示,ADC值与TNM分期呈负相关性(r=-0.619,P<0.05)。结论结直肠癌患者MSCT灌注参数、MR-DWI的ADC值与TNM分期具有较好的相关性,可作为预测病理分期的辅助指标。

Objective To study the correlation of multi-slice spiral computed tomography(MSCT)parameters and apparent diffusion coefficient(ADC)of magnetic resonance diffusion-weighted imaging(MR-DWI)with tumor,node and metastasis(TNM)staging in patients with colorectal cancer.Methods Sixty-eight patients with colorectal cancer confirmed by pathology in the Second People’s Hospital of Jinzhong from March 2020 to September 2021 were selected as the research objects.Patients were classified by TNM staging according to the pathological results.The difference of MSCT perfusion parameters,including blood volume(BV),blood flow(BF),time to peak(TTP),permeability surface(PS),and area under the curve(ADC)values of MR-DWI in patients with different TNM stages were compared.The correlations of MSCT parameters and ADC of MR-DWI scan parameters with TNM staging were analyzed by Spearman correlation analysis.Results The pathological results showed that there were 15 cases in T1 stage,10 cases in T2 stage,30 cases in T3 stage,and 13 cases in T4 stage;there were 20 cases in N0 stage,29 cases in N1 stage,and 19 cases in N2 stage;there were 30 cases in M0 stage,and 38 cases in M1 stage.In T stage,BF of patients with T3-T4 stage was lower than that of patients with T1-T2 stage,while TTP and PS were higher than those of patients with T1-T2 stage(P<0.05);in N stage,BF of patients with N1-N2 stage was lower than that of patients with N0 stage,while TTP and PS were higher than those of patients with N0 stage(P<0.05);in M stage,BF of patients with M1 stage was lower than that of patients with M0 stage,while TTP and PS were higher than those of patients with M0 stage(P<0.05);there was no significant difference in BV among patients with different TNM stages(P>0.05).Results of Spearman correlation analysis showed that BF was negatively correlated with TNM stage(r=-0.632,P<0.05),while TTP and PS were positively correlated with TNM stage(r=0.659,0.654;P<0.05),moreover,BV was not correlated with TNM stage(r=0.206,P>0.05).In T stage,the ADC value of patients with T3-T4 stage was lower than that of patients with T1-T2 stage(P<0.05);in N stage,the ADC value of patients with N1-N2 stage was lower than that of patients with N0 stage(P<0.05);in M stage,the ADC value of patients with M1 stage was lower than that of patients with M0 stage(P<0.05).Results of Spearman correlation analysis showed that ADC value was negatively correlated with TNM staging(r=-0.619,P<0.05).Conclusions The MSCT parameters and ADC of MR-DWI have good correlation with TNM staging in patients with colorectal cancer,which can be applied as effective auxiliary indexes for clinically predict pathological staging.