MRI表观扩散系数值与前列腺癌Gleason分级的相关性

Correlation between MRI apparent diffusion coefficient and Gleason scores of prostate cancer

摘要:

目的：研究磁共振扩散加权成像（diffusion weighted imaging，DWI）及表观扩散系数（apparent diffusion coefficient，ADC）与前列腺癌Gleason分级的相关性，评价ADC值对前列腺癌危险度的预测价值。方法：回顾分析空军军医大学西京医院2015年6月至2018年1月经病理证实为前列腺癌的患者共115例，所有患者均行3.0 T MR平扫及DWI检查，b值取0和2 000 s/mm2，根据前列腺癌Gleason评分将其分为低危、中危、高危3组，低危组Gleason分值≤6，中危组分值为7，高危组分值≥8。将各组前列腺癌ADC值进行单因素方差分析，并行组间两两比较；采用Pearson相关分析法分析ADC值与Gleason评分的相关性。结果：115例患者共选取129个感兴趣区（region of interest，ROI），其中低危组29例（Gleason评分5分4例、6分25例），中危组48例（7分48例），高危组52例（8分21例、9分24例、10分7例）。其中3组ADC值分别为（1.066±0.111）×10-3 mm2/s、（0.782±0.129）×10-3 mm2/s、（0.667±0.108）×10-3 mm2/s，组间差异有统计学意义（F=108.764，P=0.000）。多重比较显示，任2组间差异均有统计学意义（P=0.000），ADC值与Gleason评分相关分析结果显示两者呈显著负相关（r=-0.768，P=0.000）。结论：ADC值与Gleason分级呈明显负相关，通过ADC值有望对前列腺癌Gleason分级进行预测。

Abstract:

Objective：To study the correlation between apparent diffusion coefficient（ADC） values obtained with diffusion weighted imaging（DWI） and Gleason scores of prostate cancer，and to evaluate the predictive value of ADC for prostate cancer risk. Methods：A retrospective study was performed to 115 patients with prostate cancer confirmed by pathology in Xijing Hospital of Air Force Military Medical University from June 2015 to January 2018. All patients underwent 3.0T MRI scan and DWI examination，with b values of 0 and 2 000 s/mm2，and they were divided into three groups according to Gleason scores，low risk group（Gleason score≤6），intermediate risk group（Gleason score=7） and high risk group（Gleason score≥8）. The ADC values of prostate cancer in each group were analyzed by one-way variance and compared in pairs between groups. Pearson correlation analysis was used to explore the correlation between ADC values and Gleason scores. Results：There were 129 regions of interest（ROI） selected from 115 patients，with 29 ROIs of low risk group，48 ROIs of intermediate risk group，and 52 ROIs of high risk group. The mean and standard deviation of the ADC values of the three groups were （1.066±0.111）×10-3 mm2/s，（0.782±0.129）×10-3 mm2/s and （0.667±0.108）×10-3 mm2/s，with statistical significance（F=108.764，P=0.000） between the three groups. Multiple comparisons showed that the differences between any two groups were statistically significant（P=0.000），and the correlation analysis between ADC value and Gleason score showed a significant negative correlation（r=-0.768，P=0.000）. Conclusion：ADC values show a negative correlation with Gleason scores of prostate can－cer，which is expected to predict Gleason scores according to the ADC values.