| 摘要: |
| ［摘要］ 目的 分析磁共振表观扩散系数（ADC）值、ADC比值（rADC）鉴别诊断低危和中高危前列腺癌的效能。方法 选择2018年1月至2021年12月郑州市第七人民医院收治的前列腺癌患者62例，均经病理检查确诊。依据Gleason评分将其分为中高危组（Gleason评分≥7分，37例）和低危组（Gleason评分≤6分，25例）。测量所有患者癌灶ADC值，并以癌灶对侧、膀胱内尿液和臀大肌为参考，计算相应的rADC。采用Spearman秩相关分析探讨癌灶ADC值、rADC与Gleason分级的关系。采用受试者工作特征（ROC）曲线评价ADC值、rADC鉴别诊断低危和中高危前列腺癌的效能。结果 与低危组比较，中高危组的ADC值、rADC均较低，差异有统计学意义（P<0.05）。Spearman秩相关分析结果显示，前列腺癌患者ADC值与Gleason分级呈负相关（rs=-0.639，P=0.000），rADC癌灶对侧、rADC膀胱、rADC膀胱与Gleason分级均呈负相关（rs=-0.578，P=0.000；rs=-0.640，P=0.000；rs=-0.603，P=0.000）。ROC曲线分析结果显示，ADC值、rADC癌灶对侧、rADC膀胱、rADC膀胱均可用于鉴别低危与中高危前列腺癌（P<0.05），其中以rADC膀胱的诊断效能最高（AUC=0.815）。结论 ADC值、rADC可应用于鉴别低危与中高危前列腺癌，有助于术前评估前列腺癌的生物学特性。 |
| 关键词: 前列腺癌 磁共振 表观扩散系数 Gleason分级 |
| DOI：10.3969/j.issn.1674-3806.2022.11.15 |
| 分类号:R 737.25 |
| 基金项目: |
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| Analysis on the efficacy of ADC value and rADC in differential diagnosis of low-risk and intermediate-high-risk prostate cancer |
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NIE Yang-ping, YUAN Shuai, LI Yun
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Department of Magnetic Resonance, the Seventh People′s Hospital of Zhengzhou, Henan 450000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the efficacy of apparent diffusion coefficient(ADC) value and ADC ratio(rADC) of magnetic resonance in differential diagnosis of low-risk and intermediate-high-risk prostate cancer. Methods Sixty-two prostate cancer patients admitted to the Seventh People′s Hospital of Zhengzhou from January 2018 to December 2021 were selected, all of whom were confirmed by pathological examination. According to different Gleason scores, the patients were divided into intermediate-high-risk group(Gleason scores ≥7 points, 37 cases) and low-risk group(Gleason scores ≤6 points, 25 cases). The ADC values of cancer foci were measured in all the patients, and the corresponding rADC was calculated with reference to the contralateral side of the cancer foci, bladder urine and gluteus maximus. Spearman rank correlation analysis was used to explore the relationship between ADC value, rADC and Gleason grade of the cancer foci. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic efficacy of ADC value and rADC in differentiating low-risk prostate cancer from intermediate-high-risk prostate cancer. Results Compared with those of the low-risk group, the ADC value and rADC of the intermediate-high-risk group were low, and the differences were statistically significant(P<0.05). The results of Spearman rank correlation analysis showed that the ADC value of the prostate cancer patients was negatively correlated with Gleason grade(rs=-0.639, P=0.000). The rADC on the contralateral side of the cancer foci(rADCcontralateral side of the cancer foci), the rADC of the bladder(rADCbladder), and the rADC of gluteus maximus(rADCgluteus maximus) were all negatively correlated with Gleason grade(rs=-0.578, P=0.000; rs=-0.640, P=0.000; rs=-0.603, P=0.000). The results of ROC curve analysis showed that ADC value, rADCcontralateral side of the cancer foci, rADCbladder, and rADCgluteus maximus could all be used to differentiate low-risk prostate cancer from intermediate-high-risk prostate cancer(P<0.05), and rADCbladder had the highest diagnostic efficacy［area under the curve(AUC)=0.815］. Conclusion The ADC value and rADC can be used to differentiate low-risk prostate cancer from intermediate-high-risk prostate cancer, and help to evaluate the biological characteristics of prostate cancer before surgery. |
| Key words: Prostate cancer Magnetic resonance Apparent diffusion coefficient(ADC) Gleason grade |
