表观弥散系数预测评估鼻咽癌淋巴结放化疗后早期疗效的价值

发布时间：2018-04-24 22:11

本文选题：鼻咽癌 + 淋巴结　；参考：《广东医学》2014年24期

【摘要】：目的通过测量、分析鼻咽癌转移性淋巴结放化疗前后的相关表观弥散系数(ADC)指标,探讨ADC值在预测鼻咽癌转移性淋巴结放射敏感性以及辅助评估放化疗后早期疗效中的应用价值。方法共收入符合纳入标准的鼻咽癌患者60例,淋巴结115枚。分别测量靶病灶放化疗前后的平均ADC(ADCmean)、最小ADC值(ADCmin)和体积(V),计算放化疗前后的ADC差值(ΔADC)、ADC变化率(ΔADC%)及体积变化率(ΔV%),分析各ADC指标与ΔV%之间的相关性,并将淋巴结分为有效组(CR+PR,n=92)及无效组(SD+PD,n=23),比较两组间各ADC指标的差异。结果放化疗前ADCmean、ADCmin与ΔV%均无明显相关性,而ΔADC及ΔADC%(包括ADCmean、ADCmin)与ΔV%均呈负相关,其中ΔADCmean与ΔV%间的相关系数最大(r=-0.427,P0.01)。放化疗后有效组及无效组间治疗前ADC值(ADC0)差异无明显统计学意义,ΔADC及ΔADC%差异有统计学意义(P0.05)。绘制ADC各指标的ROC曲线,ADCmean的曲线下面积最大。结论放疗前ADC尚不能作为预测鼻咽癌转移性淋巴结放疗敏感性及放化疗后早期疗效的指标,而ΔADCmean可作为评估其早期疗效的辅助指标。
[Abstract]:Objective to analyze the apparent diffusion coefficient (ADC) index of metastatic lymph node in nasopharyngeal carcinoma (NPC) before and after radiotherapy and chemotherapy, to explore the value of ADC in predicting the radiosensitivity of metastatic lymph nodes in nasopharyngeal carcinoma and to evaluate the application value of the early curative effect after radiotherapy and chemotherapy. Method total income conforms to 60 cases of nasopharyngeal carcinoma and 115 lymph nodes. The average ADC (ADCmean), the minimum ADC value (ADCmin) and volume (V) before and after radiotherapy and chemotherapy were measured, and the ADC difference (delta ADC), the ADC change rate (delta ADC%) and the volume change rate (delta V%) were calculated before and after radiotherapy and chemotherapy, and the correlation between the ADC index and the delta V% was analyzed, and the lymph nodes were divided into effective groups and ineffective groups. There was no significant correlation between the ADC indexes between the two groups. Results there was no significant correlation between ADCmean, ADCmin and delta V% before and after chemotherapy, while the delta ADC and delta ADC% (including ADCmean, ADCmin) were negatively correlated with delta V%, and the correlation coefficient between Delta ADCmean and delta V% was the largest (r=-0.427,). Significance, the difference between Delta ADC and delta ADC% had statistical significance (P0.05). The ROC curve of each index of ADC was plotted and the area under the curve of ADCmean was the largest. Conclusion before radiotherapy ADC could not be used to predict the sensitivity of radiotherapy in nasopharyngeal carcinoma and the early effect after radiotherapy and chemotherapy, and delta ADCmean can be used as an auxiliary index to evaluate the early effect of the radiotherapy.

【作者单位】：中山大学肿瘤防治中心影像介入中心、华南肿瘤学国家重点实验室、肿瘤医学协同创新中心;
【基金】：广东省医学科研基金资助项目(编号:A2013218)
【分类号】：R739.63

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