IVIM在前列腺癌诊断中的价值及其与第八版AJCC临床病理分级的相关性研究

目的分析体素内不相干运动(IVIM)相关定量参数在前列腺癌诊断中的价值并分析其与临床病理分级的相关性。方法连续搜集经穿刺或根治切除术病理证实的63例前列腺病例,其中前列腺癌31例,前列腺增生32例。两组患者均采用IVIM模型计算得出病灶的标准水分子扩散系数(Ds)、纯水分子扩散系数(D)、快速水分子扩散系数(D^*)及灌注分数(f),利用受试者工作特征(ROC)曲线分析其对前列腺癌的诊断效能。评估以上参数与美国癌症联合会(AJCC)第8版前列腺癌临床病理分级的相关性,P<0.05认为差异有统计学意义。结果前列腺增生组的Ds、D值及f值显著高于前列腺癌组(P值均为0.000)。AJCC前列腺癌不同临床病理分级的组间Ds、D值及f值差异均有统计学意义(P<0.05),其中D值具有最大的诊断效能(AUC=0.964)。D^*值在不同临床分级的PCa组间比较差异无统计学意义(P>0.05)。Ds、D及f值与AJCC临床分级呈负相关(r值分别为-0.612、-0.946及-0.610,P=0.000)。结论IVIM参数定量分析对前列腺癌有较高的诊断价值,其中D值诊断效能最高,且有助于判断前列腺癌的侵袭性及预后情况。

The Value of IVIM in the Diagnosis of Prostate Cancer and Its Correlation with The Eighth Edition of AJCC Clinical Pathological Grade

Objective To investigate the value of the related parameters of intra-voxel incoherent motion imaging(IVIM)in differential diagnosis of prostate cancer,and its relationship with pathological grade.Methods Sixty-three cases of prostate disease confirmed by puncture or radical resection were successfully collected,including 31 cases of prostate cancer(PCa)and 32 cases of benign prostatic hyperplasia(BPH).The parameters of standard apparent diffusion coefficient values,pure apparent diffusion coefficient values,fast apparent diffusion coefficient values,and fraction of fast apparent diffusion coefficient in both groups were calculated by using the IVIM model.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of these parameters on PCa and BPH.The correlation between these parameters and the clinical pathological grades of PCa in the 8 th edition of the American Joint Committee on Cancer(AJCC)was evaluated,respectively.P<0.05 was considered as statistically significant.Results The Ds,D values,and f in the BPH group were significantly higher than those in the PCa group(P=0.000).There were significant differences in the Ds values,D values and f between the different clinical pathological grades of AJCC prostate cancer,respectively(All P<0.05);the D values had the highest diagnostic efficacy(AUC=0.964).The D^*value was not statistically significant between different clinical pathological grades in the PCa group(P>0.05).Ds,D and f were inversely correlated with clinical pathological grade of AJCC(r=-0.612,-0.946,and-0.610,respectively)(All P=0.000).Conclusion Quantitative analysis of the parameters of IVIM is valuable for the diagnosis of PCa.The slow ADC value has the highest diagnostic efficiency and is helpful for evaluating the aggressiveness and prognosis of PCa.