ADC值在前列腺中央腺体癌中的诊断价值及与Gleason评分的相关性研究

Value of apparent diffusion coefficient in central gland prostate cancer diagnosis and its correlation with Gleason Score

摘要:

目的：探讨表观扩散系数（apparent diffusion coefficient，ADC）值对前列腺中央腺体癌的诊断价值及与前列腺癌病理Gleason评分的相关性。方法：回顾性分析经病理证实的20例前列腺中央腺体癌患者常规核磁共振成像（magnetic resonance imaging，MRI）和扩散加权成像（diffusion weighted imaging，DWI）资料，并以20例前列腺增生（benign prostatic hyperplasia，BPH）患者作为对照组，比较2组间的ADC值。绘制受试者工作特性曲线（receiver operating characteristic curve，ROC），评价ADC值对前列腺中央腺体癌的诊断效能。根据Gleason评分将中央腺体癌分为低、中、高危组（≤6分为低危组，=7分为中危组，≥8分为高危组），比较各组间的ADC值，采用Spearman相关性分析评价３组ADC值与Gleason评分的相关性。结果：中央腺体癌组ADC值和BHP组ADC值两者间差异具有统计学意义（t=-4.361，P=0.000）。以ADC值1.158×10-3 mm2/s作为阈值，ROC曲线下面积为0.823，其诊断前列腺中央腺体癌的敏感性和特异性分别为80.8%和80.0%。中央腺体癌低、中、高危组ADC值差异有统计学意义（F=5.193，P=0.014），组间两两比较时，低危组和中危组、低危组和高危组ADC值差异均具有统计学意义（P=0.008、P=0.021），中危组与高危组差异无统计学意义（P=0.869）；低危组和中高危组差异具有统计学意义（t=3.286，P=0.003）。中央腺体癌组ADC值与Gleason评分呈负相关（rs=-0.469，P=0.016）。结论：ADC值对前列腺中央腺体癌的诊断具有一定的价值，ADC值与中央腺体癌Gleason评分呈负相关，可以反映前列腺癌的分化程度。

Abstract:

Objective：To investigate the apparent diffusion coefficient（ADC） in dignosis of central gland prostate cancer and its corre－lation with Gleason score. Methods：The conventional MRI and DWI data of 20 cases of central gland prostate cancer and 20 cases of benign prostatic hyperplasia（BPH） were retrospectively analyzed. ADC between two groups were compared. ROC curves was used to evaluate the efficacy of ADC in diagnosing central gland prostate cancer. According to the results of Gleason score，the lesions were divided into 3 groups：low-risk group≤6 score，intermediate-risk group=7 score and high-risk group≥8 score. ADC between groups were compared and Spearman correlation analysis was used to evaluate the correlation between Gleason score and ADC. Results：There were statistically differences in ADC between central gland prostate cancer group and benign prostatic hyperplasia group（t=-4.361，P=0.000）. When the cutoff value was 1.158×10-3 mm2/s，the area under the ROC curve was 0.823. The diagnostic sensitivity，specificity was 80.8% and 80.0%. There were statistical differences in ADC among three groups in central gland prostate cancer（F=5.193，P=0.014）. There were statistical differences in ADC between low-risk group and intermediate-risk group，low-risk group and high-risk group（P=0.008，P=0.021）. There was no difference between the intermediate-risk and high-risk group in ADC（P=0.869），while there were statistical differences between low-risk and high-risk group in ADC（t=3.286，P=0.003）. Central gland prostate cancer showed negative correlation with Gleason score（r=-0.469，P=0.016）. Conclusion：ADC values have certain value in the diagnosis of prostate cancer in the central gland. ADC and central gland cancer Gleason score are negatively correlated. ADC may reflect the degree of differentiation of prostate cancer.