子宫内膜癌肿瘤体积与子宫体积比值联合肿瘤ADC值对病理分级的预测价值

Prediction value of tumor volume to uterine volume ratio combined with tumor ADC value in pathological grading of endometrial carcinoma

目的探讨子宫内膜癌(EC)肿瘤体积与子宫体积比值(N/U)联合肿瘤表观扩散系数(ADC)值对EC病理分级的预测价值。方法回顾性分析2020年7月至2023年1月收治的107例EC患者的资料,所有患者术前均进行了磁共振(MRI)检查,将病理学诊断作为金标准。将低分化患者纳入高级别组,中、高分化纳入低级别组。分析影响EC患者病理分级的因素,分析MRI指标预测EC患者病理分级的价值。结果手术病理检测显示高级别患者24例,低级别患者83例。Logistic多因素回归分析显示:N/U、ADC、rADC闭孔内肌是影响EC患者病理分级的因素(P<0.05)。ROC曲线结果显示,N/U、ADC、rADC_(闭孔内肌)及三者联合预测EC患者病理分级的灵敏度分别为70.83%、75.00%、79.17%、83.33%,特异度分别为71.08%、79.52%、78.31%、85.54%,AUC分别为0.734、0.756、0.741、0.891。结论N/U、ADC、rADC_(闭孔内肌)三者联合预测EC患者术前病理分级效能良好。

Objective To investigate the value of tumor volume to uterine volume ratio(N/U)combined with tumor apparent diffusion coefficient(ADC)in predicting the pathological grade of endometrial carcinoma(EC).Methods Data of 107 patients with EC admitted from July 2020 to January 2023 were retrospectively analyzed.All patients underwent preoperative magnetic resonance imaging(MRI),and pathological diagnosis was used as the gold standard.Patients with low differentiation were included in the high grade group,and patients with medium and high differentiation were included in the low grade group.The factors affecting the pathological grading of EC patients were analyzed,and the value of MRI index in predicting the pathological grading of EC patients was analyzed.Results The pathological examination showed that there were 24 high-grade patients and 83 low-grade patients..Logistic multivariate regression analysis showed that N/U,ADC,rADC internal obturator muscle were factors affecting the pathological grade of EC patients(P<0.05).ROC curve results showed that the sensitivity of N/U,ADC,rADC internus obturator muscle and their combination to predict the pathological grading of EC patients were 70.83%,75.00%,79.17%,83.33%,the specificity were 71.08%,79.52%,78.31%,85.54%,and the AUC were 0.734,0.756,0.741 and 0.891.Conclusion The combination of N/U,ADC,rADC and obturator internal muscle was effective in predicting the preoperative pathological grading of EC patients.