IVIM定量参数联合血清内脏脂肪素水平对前列腺癌根治性术后复发/转移的预测分析

Predictive Analysis of IVIM Quantitative Parameters Combined with Serum Visfatin Levels for Postoperative Recurrence/Metastasis of Prostate Cancer after Radical Surgery

目的分析体素内不相干运动成像(IVIM)定量参数联合血清内脏脂肪素水平对前列腺癌根治术后复发/转移的预测价值。方法纳入2015年4月-2021年10月在湖南中医药大学第二附属医院拟行前列腺癌根治术治疗的100例患者作为研究对象,所有患者均在出院后跟踪随访18个月,统计随访期间患者复发/转移情况并分为发生组(39例)与未发生组(61例)。比较两组前列腺组织的IVIM定量参数[真实扩散系数(D)、伪扩散系数(D)、灌注分数(f)]、血清内脏脂肪素水平及其他基线资料,探讨前列腺癌根治术后复发/转移的影响因素,评价IVIM定量参数联合血清内脏脂肪素水平对前列腺癌根治术后复发/转移的预测价值。结果发生组Gleason评分、入院时PSA水平均高于未发生组,差异有统计学意义(P<0.05);发生组D、D值低于未发生组,f及内脏脂肪素高于未发生组,差异有统计学意义(P<0.05);经多因素Logistics回归分析结果显示,D、D、f、内脏脂肪素水平高是前列腺癌根治术后复发/转移的影响因素(P<0.05);ROC曲线显示,IVIM定量参数(D、D、f)、血清内脏脂肪素对前列腺癌根治术后复发/转移均有一定预测价值(AUC均>0.7),但两者联合预测患者复发/转移的AUC最大。结论IVIM定量参数联合血清内脏脂肪素水平可有效预测前列腺癌根治术后复发/转移风险,为临床治疗提供一定的理论参考。

Objective To analyze the predictive value of intravoxel incoherent motion imaging(IVIM)quantitative parameters combined with serum visfatin levels for postoperative recurrence/metastasis of prostate cancer after radical surgery.Methods A total of 100 patients who underwent radical prostatectomy at the Second Affiliated Hospital of Hunan University of Chinese Medicine from April 2015 to October 2021 were included as the study subjects.All patients were followed up for 18 months after discharge,and the recurrence/metastasis status of the patients during the follow-up period was analyzed and divided into an occurrence group(39 cases)and a non occurrence group(61 cases).The IVIM quantitative parameters of prostate tissue[true diffusion coefficient(D),pseudo diffusion coefficient(D),perfusion fraction(f)],serum visfatin level and other baseline data were compared between the two groups.The influencing factors of recurrence/metastasis after radical prostatectomy was explored,and the predictive value of IVIM quantitative parameters combined with serum visfatin level for recurrence/metastasis after radical prostatectomy was evaluted.Results The Gleason score and PSA level at admission in the occurrence group were higher than those in the non occurrence group,with a statistical significant difference(P<0.05).The D and D values in the occurrence group were lower than those in the non occurrence group,while the f and visfatin levels were higher than those in the non occurrence group,with statistical significant differences(P<0.05).The results of multivariate Logistic regression analysis showed that high levels of D,D,f,and visfatin were the influencing factors for postoperative recurrence/metastasis of prostate cancer after radical surgery(P<0.05).The ROC curve showed that the quantitative parameters of IVIM(D,D,f)and serum visfatin had certain predictive value for postoperative recurrence/metastasis of prostate cancer(AUC>0.7).However,the AUC of the combined prediction of recurrence/metastasis was the largest.Conclusion The combination of quantitative parameters of IVIM and serum visfatin levels can effectively predict the risk of recurrence/metastasis after radical prostatectomy,providing a theoretical reference for clinical treatment.