重庆医学
重慶醫學
중경의학
Chongqing Medicine
2015年
29期
4102-4105
,共4页
王卓楠%马超豪%罗天友%彭娟%张志伟
王卓楠%馬超豪%囉天友%彭娟%張誌偉
왕탁남%마초호%라천우%팽연%장지위
前列腺肿瘤%标化ADC值%Gleason评分%磁共振成像
前列腺腫瘤%標化ADC值%Gleason評分%磁共振成像
전렬선종류%표화ADC치%Gleason평분%자공진성상
prostatic neoplasms%standardized apparent diffusion coefficient value%Gleason score%magnetic resonance imaging
目的：比较表观扩散系数（ADC）值和标化ADC值在诊断前列腺癌恶性程度中的价值。方法回顾性分析经病理证实的34例前列腺癌的弥散加权成像（DWI）扫描结果。测量患者49个癌灶及外周带正常区域的ADC值，计算癌灶标化 ADC值。根据病理Gleason评分，49个癌灶分为：≤6分（低危组）、7分（中危组）、≥8分（高危组）共3组。对各组ADC值之间和标化ADC值之间的差别及ADC值和标化ADC值与Gleason评分之间的相关性进行统计学分析。结果前列腺癌 ADC值及标化ADC值3组整体差异均有统计学意义（P＜0．01），但两两比较ADC值在中危组与高危组之间差异无统计学意义（P＞0．05），而标化ADC值在各组间差异均有统计学意义（ P＜0．05）。ADC值（ r＝－0．546，P＝0．000）和标化 ADC 值（ r＝－0．575，P＝0．000）与Gleason评分均呈负相关。在比较前列腺癌各组的ROC曲线下面积时，标化ADC值与ADC值之间的差异无统计学意义（P＞0．05），但当特异性调整至100％时，标化ADC值在区别低危组与中危组、低危组与高危组时较ADC值具有更高的灵敏性（47．5％ vs ．5．6％、78．2％ vs ．50．9％）。结论 ADC值和标化ADC值与Gleason评分均呈负相关，但标化ADC值在诊断前列腺癌恶性程度方面可能具有更高的效能。
目的：比較錶觀擴散繫數（ADC）值和標化ADC值在診斷前列腺癌噁性程度中的價值。方法迴顧性分析經病理證實的34例前列腺癌的瀰散加權成像（DWI）掃描結果。測量患者49箇癌竈及外週帶正常區域的ADC值，計算癌竈標化 ADC值。根據病理Gleason評分，49箇癌竈分為：≤6分（低危組）、7分（中危組）、≥8分（高危組）共3組。對各組ADC值之間和標化ADC值之間的差彆及ADC值和標化ADC值與Gleason評分之間的相關性進行統計學分析。結果前列腺癌 ADC值及標化ADC值3組整體差異均有統計學意義（P＜0．01），但兩兩比較ADC值在中危組與高危組之間差異無統計學意義（P＞0．05），而標化ADC值在各組間差異均有統計學意義（ P＜0．05）。ADC值（ r＝－0．546，P＝0．000）和標化 ADC 值（ r＝－0．575，P＝0．000）與Gleason評分均呈負相關。在比較前列腺癌各組的ROC麯線下麵積時，標化ADC值與ADC值之間的差異無統計學意義（P＞0．05），但噹特異性調整至100％時，標化ADC值在區彆低危組與中危組、低危組與高危組時較ADC值具有更高的靈敏性（47．5％ vs ．5．6％、78．2％ vs ．50．9％）。結論 ADC值和標化ADC值與Gleason評分均呈負相關，但標化ADC值在診斷前列腺癌噁性程度方麵可能具有更高的效能。
목적：비교표관확산계수（ADC）치화표화ADC치재진단전렬선암악성정도중적개치。방법회고성분석경병리증실적34례전렬선암적미산가권성상（DWI）소묘결과。측량환자49개암조급외주대정상구역적ADC치，계산암조표화 ADC치。근거병리Gleason평분，49개암조분위：≤6분（저위조）、7분（중위조）、≥8분（고위조）공3조。대각조ADC치지간화표화ADC치지간적차별급ADC치화표화ADC치여Gleason평분지간적상관성진행통계학분석。결과전렬선암 ADC치급표화ADC치3조정체차이균유통계학의의（P＜0．01），단량량비교ADC치재중위조여고위조지간차이무통계학의의（P＞0．05），이표화ADC치재각조간차이균유통계학의의（ P＜0．05）。ADC치（ r＝－0．546，P＝0．000）화표화 ADC 치（ r＝－0．575，P＝0．000）여Gleason평분균정부상관。재비교전렬선암각조적ROC곡선하면적시，표화ADC치여ADC치지간적차이무통계학의의（P＞0．05），단당특이성조정지100％시，표화ADC치재구별저위조여중위조、저위조여고위조시교ADC치구유경고적령민성（47．5％ vs ．5．6％、78．2％ vs ．50．9％）。결론 ADC치화표화ADC치여Gleason평분균정부상관，단표화ADC치재진단전렬선암악성정도방면가능구유경고적효능。
Objective To compare the value of apparent diffusion coefficient (ADC) value and the standardized apparent dif‐fusion coefficient (ADC) value in diagnosing malignancy degree of prostate cancer .Methods Diffusion weighted imaging (DWI) results of 34 patients with prostate cancer proved pathologically were retrospectively analyzed .The ADC values in 49 lesions and normal peripheral zones of the prostates of the patients were measured .Then ,ADC values of the lesions were calculated .According to the results of Gleason score ,the lesions were divided into 3 groups:Gleason score≤6 (low‐risk group) ,Gleason score=7 (inter‐mediate‐risk group) and Gleason score≥8 (high‐risk group) .Statistical analysis was performed to evaluate the differences of the ADC values and sADC values in three groups ,and to evaluate the correlation between Gleason score and ADC value or sADC value . Results There were statistically differences overall in ADC values and sADC values of the three groups (P<0 .01) .There was no difference between the intermediate‐risk and high‐risk group in ADC values (P> 0 .05) ,however ,there were difference between sADC values of three groups each other (P< 0 .05) .ADC values (r= -0 .546 ,P=0 .000) and sADC values (r= -0 .575 ,P=0 .000) showed all negative correlation with Gleason score .There were no differences between sADC values and ADC values of three groups in areas under the receiver operating characteristic curve (AUCs) (P>0 .05) .However ,when change the specificity to 100% ,sADC had higher sensitivity than ADC values (47 .5% vs .5 .6% ,78 .2% vs .50 .9% ) in differentiating low‐risk from inter‐mediate‐risk group ,and low‐risk from high‐risk group .Conclusion ADC value and sADC value showed all negative correlation with Gleason score ,but sADC value may be of higher performance in diagnosing malignancy degree of prostate cancer .
