MR表观扩散系数预测鼻咽癌放疗敏感度及相关因素分析

发布时间：2018-11-11 13:57

【摘要】：目的探讨利用MR扩散加权成像的表观扩散系数(ADC值)预测鼻咽癌放疗敏感度的可行性。方法 97例鼻咽癌患者在放疗前行MR扩散加权成像检查,并测量肿瘤灶ADC值。根据放射治疗后的效果将鼻咽癌患者按放疗敏感度进行分组,放疗敏感组74例、放疗抗拒组23例。分析放疗敏感度与ADC值、病理分型、T分期的相互关系。结果放疗敏感组的ADC值为(0.792±0.121)×10-3mm2/s,其中非角化型分化型癌23例,非角化型未分化癌51例,T1期10例,T2期33例,T3期22例,T4期9例。放疗抗拒组的ADC值为(0.730±0.104)×10-3 mm2/s,其中非角化型分化型癌8例,非角化型未分化癌15例,T1期3例,T2期4例,T3期7例,T4期9例。两组间在ADC值、T分期方面差异均有统计学意义(t=2.199,P=0.030;χ2=10.287,P=0.016),在病理分型方面差异无统计学意义(χ2=0.111,P=0.740)。各T分期的ADC值整体上差异有统计学意义(F=8.597,P=0.000),随着T分期的增高,ADC值呈现下降趋势。ADC值、T分期预测鼻咽癌放疗敏感度的ROC曲线下的面积(Az)值分别为0.657、0.661。当ADC值取0.737×10-3 mm2/s为诊断阈值时,其诊断价值最大,敏感度为68.9%,特异性为69.6%。结论 ADC值可以预测鼻咽癌放疗敏感度,其价值接近于T分期,最佳诊断阈值为0.737×10-3 mm2/s。
[Abstract]:Objective to study the feasibility of predicting radiotherapy sensitivity of nasopharyngeal carcinoma (NPC) by using apparent diffusion coefficient (ADC) of MR diffusion weighted imaging. Methods MR diffusion weighted imaging was performed in 97 patients with nasopharyngeal carcinoma before radiotherapy, and ADC value of tumor focus was measured. According to the effect of radiotherapy, patients with nasopharyngeal carcinoma were divided into four groups according to the sensitivity of radiotherapy, 74 cases in the radiosensitive group and 23 cases in the resistant group. The relationship between the sensitivity of radiotherapy and ADC, pathological classification and T stage was analyzed. Results the ADC values of radiotherapy sensitive group were (0.792 卤0.121) 脳 10 ~ (-3) mm ~ (-2) / s, including 23 cases of non-keratinizing differentiated carcinoma, 51 cases of non-keratinized undifferentiated carcinoma, 10 cases of T1 stage, 33 cases of T2 stage, 22 cases of T3 stage and 9 cases of T4 stage. The ADC values of radiotherapy resistant group were (0.730 卤0.104) 脳 10 ~ (-3) mm2/s, including 8 cases of non-keratinizing differentiated carcinoma, 15 cases of non-keratinized undifferentiated carcinoma, 3 cases of T1 stage, 4 cases of T2 stage, 7 cases of T3 stage and 9 cases of T4 stage. There were significant differences in ADC and T staging between the two groups (t = 2.199P = 0.030; 蠂 ~ 2 = 10.287 / P = 0.016), but there was no significant difference in pathological classification between the two groups (蠂 ~ 2 / 0.111 / P ~ (0.740). The ADC value of each T stage was significantly different (F = 8.597, P < 0. 000). With the increase of T stage, the ADC value showed a downward trend. The area (Az) values under the ROC curve for predicting radiotherapy sensitivity of nasopharyngeal carcinoma by T staging were 0.657 卤0.661respectively. When the ADC value was 0.737 脳 10 ~ (-3) mm2/s, the diagnostic value was the highest, the sensitivity was 68.9 and the specificity was 69.6. Conclusion ADC value can predict the radiosensitivity of nasopharyngeal carcinoma, and its value is close to T stage. The best diagnostic threshold is 0.737 脳 10 ~ (-3) mm2/s..
【作者单位】：广州医科大学附属肿瘤医院核医学科;广州医科大学附属肿瘤医院放射科;
【基金】：广州市医药卫生科技项目(20141A011093)
【分类号】：R739.63

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