DCE-MRI定量参数与进展期胰腺癌病理特征的相关性及预测化疗早期疗效的价值

Correlation between the Quantitative Parameters of DCE-MRI and the Pathological Features of Advanced Pancreatic Cancer and the Value of Predicting the Early Efficacy of Chemotherapy

目的探讨动态对比增强MRI(DCE-MRI)定量参数与进展期胰腺癌病理特征的相关性及预测化疗早期疗效的价值。方法选取2020年4月~2022年4月我院进展期胰腺癌患者84例。治疗前2周内及治疗1个月均进行DCE-MRI检查,对其药代动力学参数的Vp值、Kep值以及Ktrans值进行测量,并在治疗前对DCE-MRI定量参数和病理特征之间的相关性进行分析,比较进展组与稳定组治疗前、治疗1个月DCEMRI定量参数,对接受试验的患者工作特征(ROC)曲线的分析治疗1个月后DCE-MRI定量参数对患者化疗早期疗效的价值进行预测。结果84例进展期胰腺癌患者治疗前Ktrans值为(0.112±0.026)min,Kep值为(0.339±0.089)min,Vp值为(0.077±0.016);胰头胰腺癌相比体尾部的Vp值更高(P<0.05);低分化、有血管侵犯胰腺癌Ktrans值、Kep值、Vp值高于中高分化、无有血管侵犯(P<0.05);Ⅳ期、有淋巴转移胰腺癌Ktrans值、Kep值高于Ⅱ~Ⅲ期、无淋巴转移(P<0.05)。治疗1个月,进展组Ktrans值、Kep值未发生明显变化(P>0.05),稳定组Ktrans值、Kep值显著低于治疗前(P<0.05);治疗1个月,进展组Ktrans值、Kep值高于稳定组(P<0.05)。ROC显示,治疗1个月Ktrans值、Kep值联合联合预测疗效的AUC值最大0.783,对应敏感度为88.37%,特异度为58.54%。结论DCE-MRI定量参数可用于评估胰腺癌临床、病理状况,且参数Ktrans值、Kep值可预测早期化疗疗效。

Objective To explore the correlation between dynamic contrast-enhanced MRI(DCE-MRI)quantitative parameters and the pathological characteristics of advanced pancreatic cancer and the value of predicting the early efficacy of chemotherapy.Methods 84 patients had advanced pancreatic cancer from April 2020 to April 2022.DCE-MRI was conducted within 2 weeks before and 1 month of treatment,measured Ktrans value,Kep value,Vp value,analyzed the correlation between DCE-MRI quantitative parameters and pathological characteristics,comparing DCE-MRI quantitative parameters between progressive group and stable group,and subject working characteristics(ROC)curve analyzed the value of DCE-MRI quantitative parameters to predict the early efficacy of chemotherapy.Results 84 pre-treatment Ktrans of advanced pancreatic cancer was(0.112±0.026)min,Kep was(0.339±0.089)min,Vp was(0.077±0.016),pancreatic head was Vp was higher than the tail(P<0.05),low differentiation,Kep,Vp than vascular invasion(P<0.05),and(P<0.05).After 1 month of treatment,Ktrans and Kep did not change significantly(P>0.05),and those in stable group were significantly lower than those before treatment(P<0.05).After 1 month of treatment,Ktrans and Kep in progressive group were higher than those in stable group(P<0.05).ROC showed that the maximum AUC value of Ktransvalue and Kep value was 0.783,corresponding to a sensitivity of 88.37%and a specificity of 58.54%.Conclusion The DCEMRI quantitative parameters can be used to evaluate the clinical and pathological status of pancreatic cancer,and the parameter Ktrans value and Kep value can predict the efficacy of early chemotherapy.