表观扩散系数在乳腺癌肝转移早期疗效评价中的应用

发布时间：2018-11-21 20:01

【摘要】：目的应用表观扩散系数(ADC)值预测和早期评价乳腺癌肝转移(BCLMs)化疗效果。方法搜集40例乳腺癌肝转移患者,共69个转移灶,均行多西他赛联合卡培他滨(TX)化疗方案,于化疗前3~4天和化疗后1个月行普通平扫及扩散加权成像(DWI)并测定ADC值。采用实体瘤疗效评价标准(RECIST)划分有效组与无效组。结果在69个转移灶中,31个病灶有效,38个病灶无效,化疗前后ADC值分别为(1.26±0.35)×10-3mm2/s和(1.37±0.32)×10-3mm2/s(t=3.468,P0.05);有效组与无效组化疗前ADC值分别为(1.16±0.24)×10-3mm2/s和(1.35±0.44)×10-3mm2/s(t=2.142,P0.05);有效组与无效组化疗后ADC值分别为(1.46±0.30)×10-3mm2/s和(1.31±0.34)×10-3mm2/s(t=1.647,P0.05);有效组化疗前后ADC值分别为(1.16±0.24)×10-3mm2/s和(1.46±0.30)×10-3mm2/s(t=9.881,P0.000);无效组化疗前后ADC值分别为(1.35±0.44)×10-3mm2/s和(1.31±0.34)×10-3mm2/s(t=1.341,P0.05);绘制受试者工作特征(ROC)曲线,约登指数=1.27,b值为700时,取ADC=1.37×10-3mm2/s作为判断化疗是否有效的界值,曲线下面积(AUC):0.678,95%可信区间(CI):55%~83%。结论 ADC值可以早期定量预测BCLMs化疗效果。
[Abstract]:Objective to predict and evaluate the effect of (BCLMs) chemotherapy for liver metastases of breast cancer by using the apparent diffusion coefficient (ADC). Methods Forty patients with liver metastases from breast cancer were collected and received docetaxel combined with capecitabine (TX) chemotherapy regimen. Conventional plain scan and diffusion weighted imaging (DWI) were performed 3 days before chemotherapy and 1 month after chemotherapy and ADC values were measured. The effective group and the ineffective group were divided into effective group and ineffective group by using (RECIST) criteria for evaluating the curative effect of solid tumor. Results among 69 metastatic foci, 31 were effective and 38 were ineffective. The ADC values before and after chemotherapy were (1.26 卤0.35) 脳 10-3mm2/s and (1.37 卤0.32) 脳 10-3mm2/s (t = 3.468), respectively. The ADC values before chemotherapy in effective group and ineffective group were (1.16 卤0.24) 脳 10-3mm2/s and (1.35 卤0.44) 脳 10-3mm2/s, respectively. The ADC values of effective group and ineffective group after chemotherapy were (1.46 卤0.30) 脳 10-3mm2/s and (1.31 卤0.34) 脳 10-3mm2/s (t = 1.647), respectively. The ADC values before and after chemotherapy in the effective group were (1.16 卤0.24) 脳 10-3mm2/s and (1.46 卤0.30) 脳 10-3mm2/s (t 9.881g, P 0.000), respectively. The ADC values before and after chemotherapy in the ineffective group were (1.35 卤0.44) 脳 10-3mm2/s and (1.31 卤0.34) 脳 10-3mm2/s respectively (P 0.05). The operating characteristic (ROC) curve was drawn. When the Yorden index = 1.27nb was 700, ADC=1.37 脳 10-3mm2/s was taken as the threshold value to judge the effectiveness of chemotherapy. The area under the curve was (AUC): 0.67895% confidence interval (CI): 5535. Conclusion ADC value can predict the effect of BCLMs chemotherapy in early stage.
【作者单位】：南京医科大学附属淮安第一医院影像科;
【分类号】：R445.2;R737.9

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