CAJ | 학술논문

目的：探讨磁共振全身扩散加权成像（ DWI）在肺癌的临床分期及疗效评估中的价值。方法对该院2012年1月至2014年1月收治的68例经病理组织学确诊的肺癌患者采用DWI检查，比较不同肺癌病理类型、分化程度、不同的T分期及N分期患者的表观扩散系数（ ADC）值差异；并对肺癌患者采用吉西他滨联合顺铂进行化疗，并比较治疗前1周和治疗后3个月所有肺癌患者的ADC值变化情况。结果不同组织学类型的肺癌ADC值之间存在显著的统计学差异（P＜0．05），三组间两两比较差异也具有统计学意义（P＜0．05），腺癌ADC值（1．338±0．246）×10－3 mm2· S－1明显高于鳞癌和小细胞癌。不同分化程度的肺癌ADC值差异具有统计学意义（P＜0．05），高分化组肺癌ADC值明显高于中分化、低分化组，中分化组和低分化组差异不具有统计学意义（P＞0．05）。肺癌不同T分期患者的ADC值差异具有显著统计学意义（P＜0．05），组间两两比较仅T1分期ADC值明显高于其它分期且具有统计学意义（ P＜0．05）。肺癌不同N分期患者的ADC值差异具有显著统计学意义（P＜0．05），组间两两比较仅N3分期ADC值明显低于于其他分期且具有统计学意义（P＜0．05）。治疗有效组的ADC值明显升高且差异具有统计学意义（P＜0．05）；治疗3个月后两组ADC值差异显著，有效组的ADC为（1．464±0．317）×10－3mm2· S－1明显高于无效组的（1．315±0．284）×10－3mm2· S－1且差异具有统计学意义（P＜0．05）。结论 DWI在肺癌的诊断及病理类型、分期中具有一定的临床价值，对治疗效果能够进行有效的临床评价。
목적：탐토자공진전신확산가권성상（ DWI）재폐암적림상분기급료효평고중적개치。방법대해원2012년1월지2014년1월수치적68례경병리조직학학진적폐암환자채용DWI검사，비교불동폐암병리류형、분화정도、불동적T분기급N분기환자적표관확산계수（ ADC）치차이；병대폐암환자채용길서타빈연합순박진행화료，병비교치료전1주화치료후3개월소유폐암환자적ADC치변화정황。결과불동조직학류형적폐암ADC치지간존재현저적통계학차이（P＜0．05），삼조간량량비교차이야구유통계학의의（P＜0．05），선암ADC치（1．338±0．246）×10－3 mm2· S－1명현고우린암화소세포암。불동분화정도적폐암ADC치차이구유통계학의의（P＜0．05），고분화조폐암ADC치명현고우중분화、저분화조，중분화조화저분화조차이불구유통계학의의（P＞0．05）。폐암불동T분기환자적ADC치차이구유현저통계학의의（P＜0．05），조간량량비교부T1분기ADC치명현고우기타분기차구유통계학의의（ P＜0．05）。폐암불동N분기환자적ADC치차이구유현저통계학의의（P＜0．05），조간량량비교부N3분기ADC치명현저우우기타분기차구유통계학의의（P＜0．05）。치료유효조적ADC치명현승고차차이구유통계학의의（P＜0．05）；치료3개월후량조ADC치차이현저，유효조적ADC위（1．464±0．317）×10－3mm2· S－1명현고우무효조적（1．315±0．284）×10－3mm2· S－1차차이구유통계학의의（P＜0．05）。결론 DWI재폐암적진단급병리류형、분기중구유일정적림상개치，대치료효과능구진행유효적림상평개。
Objective To investigate the value of the whole body diffusion weighted MR imaging ( DWI) in evaluation of clinical stag-ing and therapeutic effect of lung cancer.Methods 68 histologically confirmed lung cancer patients were examined by DWI in our hospital from January 2012 to January 2014,to compare different lung cancer pathological types, degree of differentiation, and ADC values of patients in T or N stage.Then these patients were treated with gemcitabine plus cisplatin chemotherapy, and ADC variation 1 week before and 3 months after the treatment were examined.Results There was a significant difference in ADC between different his-tological types of lung cancer (P<0.05), and the difference between either two in all the three groups was also statistically significant (P<0.05).The ADC value of (1.338 ±0.246) ×10 -3mm2· S-1 of adenocarcinoma was significantly higher than that of insqua-mous cell carcinoma and small cell carcinoma.ADC value of lung cancer with different differentiation degrees has significant difference (P<0.05).ADC value of high differentiation group was significantly higher than that of low differentiation group.Differences in me-dium differentiation and low differentiation groups were not statistically significant (P>0.05).ADC values of lung cancer patients in different T staging were statistically significantly different (P<0.05).Pairwise comparison between groups showed only ADC of T1 staging was higher than that of other stages and has statistical significance (P<0.05).ADC values of lung cancer patients in different N staging were statistically significantly different (P<0.05), And pairwise comparison between groups showed only ADC of N3 stage was significantly lower than that in other stages and had statistical significance ( P<0.05) .ADC of treatment group increased appar-ently and the difference was statistically significant (P<0.05); the difference in ADC value between two groups after 3 months of treatment was significant, The ADC is(1.464 ±0.317) ×10 -3 mm2 · S-1 of the effective group, which was significantly higher than that of the ineffective group (1.315 ±0.284) ×10 -3mm2· S-1 and the difference was statistically significant (P<0.05).Conclu-sions DWI will be a reliable method for lung cancer diagnosis and pathological type identification, and clinical staging.