中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2014年
12期
905-909
,共5页
马霄虹%赵心明%欧阳汉%王爽%叶枫%王孟%周纯武
馬霄虹%趙心明%歐暘漢%王爽%葉楓%王孟%週純武
마소홍%조심명%구양한%왕상%협풍%왕맹%주순무
磁共振成像%扩散加权成像%癌,肝细胞%射频消融
磁共振成像%擴散加權成像%癌,肝細胞%射頻消融
자공진성상%확산가권성상%암,간세포%사빈소융
Magnetic resonance imaging%Diffusion-weighted imaging%Carcinoma,hepatocellular%Radiofrequency ablation
目的 探讨肝细胞癌(HCC)射频消融(RFA)治疗前通过磁共振扩散加权成像(DWI)逐点分析法测得的表观扩散系数(ADC)值对其疗效的预测价值.方法 选取经病理证实的73例单发病灶HCC患者,其中疾病稳定组35例,疾病进展组38例.在RFA治疗前对全部患者行屏气DWI扫描,使用DWI逐点分析法在病灶最大层面,测得最小10％ ADC值(ADC10)、最小30％ ADC值(ADC30)、最小50％ ADC值(ADC50)以及平均ADC值(ADC100),并与非病变区域的ADC100对比,得到RADC10、RADC30、RADC50以及RADC100.结果 RFA治疗前,疾病稳定组与疾病进展组患者的ADC30、ADC50、ADC100、RADC30、RADC50以及RADC100的比较,差异均有统计学意义(均P＜0.05).全组患者的无疾病进展生存时间(PFS)为(16.0±10.6)个月.Cox单因素分析结果显示,RADC10、RADC30、RADC50与全组患者的PFS有关(均P＜0.05).Cox多因素分析结果显示,仅RADC50对全组患者的PFS有明显影响(P＜0.05).以全组患者RADC50的中位数0.72为界,将患者分为两组,RADC50 ＜0.72组患者的PFS为(30.2±3.0)个月,RADC50≥0.72组患者的PFS为(20.0±3.1)个月,差异有统计学意义(P=0.01).结论 DWI逐点分析法测得的RADC50是预测HCC患者RFA治疗疗效的最稳定和关键因素.
目的 探討肝細胞癌(HCC)射頻消融(RFA)治療前通過磁共振擴散加權成像(DWI)逐點分析法測得的錶觀擴散繫數(ADC)值對其療效的預測價值.方法 選取經病理證實的73例單髮病竈HCC患者,其中疾病穩定組35例,疾病進展組38例.在RFA治療前對全部患者行屏氣DWI掃描,使用DWI逐點分析法在病竈最大層麵,測得最小10％ ADC值(ADC10)、最小30％ ADC值(ADC30)、最小50％ ADC值(ADC50)以及平均ADC值(ADC100),併與非病變區域的ADC100對比,得到RADC10、RADC30、RADC50以及RADC100.結果 RFA治療前,疾病穩定組與疾病進展組患者的ADC30、ADC50、ADC100、RADC30、RADC50以及RADC100的比較,差異均有統計學意義(均P＜0.05).全組患者的無疾病進展生存時間(PFS)為(16.0±10.6)箇月.Cox單因素分析結果顯示,RADC10、RADC30、RADC50與全組患者的PFS有關(均P＜0.05).Cox多因素分析結果顯示,僅RADC50對全組患者的PFS有明顯影響(P＜0.05).以全組患者RADC50的中位數0.72為界,將患者分為兩組,RADC50 ＜0.72組患者的PFS為(30.2±3.0)箇月,RADC50≥0.72組患者的PFS為(20.0±3.1)箇月,差異有統計學意義(P=0.01).結論 DWI逐點分析法測得的RADC50是預測HCC患者RFA治療療效的最穩定和關鍵因素.
목적 탐토간세포암(HCC)사빈소융(RFA)치료전통과자공진확산가권성상(DWI)축점분석법측득적표관확산계수(ADC)치대기료효적예측개치.방법 선취경병리증실적73례단발병조HCC환자,기중질병은정조35례,질병진전조38례.재RFA치료전대전부환자행병기DWI소묘,사용DWI축점분석법재병조최대층면,측득최소10％ ADC치(ADC10)、최소30％ ADC치(ADC30)、최소50％ ADC치(ADC50)이급평균ADC치(ADC100),병여비병변구역적ADC100대비,득도RADC10、RADC30、RADC50이급RADC100.결과 RFA치료전,질병은정조여질병진전조환자적ADC30、ADC50、ADC100、RADC30、RADC50이급RADC100적비교,차이균유통계학의의(균P＜0.05).전조환자적무질병진전생존시간(PFS)위(16.0±10.6)개월.Cox단인소분석결과현시,RADC10、RADC30、RADC50여전조환자적PFS유관(균P＜0.05).Cox다인소분석결과현시,부RADC50대전조환자적PFS유명현영향(P＜0.05).이전조환자RADC50적중위수0.72위계,장환자분위량조,RADC50 ＜0.72조환자적PFS위(30.2±3.0)개월,RADC50≥0.72조환자적PFS위(20.0±3.1)개월,차이유통계학의의(P=0.01).결론 DWI축점분석법측득적RADC50시예측HCC환자RFA치료료효적최은정화관건인소.
Objective To evaluate the value of MR diffusion-weighted imaging (DWI) histogram analysis for predicting tumor progression in patients with hepatocellular carcinoma (HCC) treated with radiofrequency ablation (RFA).Methods In a retrospective study,both 35 stable patients and 38 progressive patients with biopsy-proven HCC underwent breath-hold DWI before RFA treatment.The pretreatment apparent diffusion coefficient (ADC) values were averaged from the lowest to 10th,30th,50th,and 100th percentile using DWI histogram analysis software respectively,and were called ADC10,ADC30,ADC50 and ADC100.The ratios of ADC10,ADC30,ADC50 and ADC100 to mean ADC of non-lesional area were calculated,called RADC10,RADC30,RADC50 and RADC100,respectively.Results Before RFA treatment,the ADC30,ADC50,ADC100,RADC30,RADC50 and RADC100 values of the tumors in the progression group were significantly higher than those of the stable group (P ＜ 0.05 for all),respectively.The progression-free survival (PFS) of all patients was(16.0 ± 10.6) months.Univariate Cox regression analysis indicated that RADC10,RADC30,RADC50 values of the tumor were significantly associated with PFS (P ＜ 0.05 for both).In multivariate analysis,only the RADC50 value of tumor was a significant predictor for tumor progression (P ＜0.05).When the cut-off value of RADC50(0.72) was used,the PFS of below the cut-off value group [(30.2 ± 3.0) months] was significantly higher than that of those above the cut-off value group [(20.0 ± 3.1) months] (P =0.01).Conclusions Pre-RFA DWI histogram analysis may serve as a biomarker for predicting tumor progression in patients with HCC treated with RFA.
