DWI对前列腺癌疗效监测及ADC值与PSA相关性研究

目的：探讨前列腺癌（PC）患者治疗前后扩散加权成像（DWI）表现及表观扩散系数（ADC）值与前列腺特异性抗原（PSA）的相关性，从而以ADC值为定量分析指标，将DWI用于PC疗效的监测与评估。方法：48例经病理证实的PC患者均行内分泌治疗，其中12例行去势手术。分别在患者治疗前及治疗后30天行常规MRI及DWI检查，测量其治疗前后的ADC值和血清PSA水平，并对其进行相关性分析。结果：48例PC患者治疗前病灶ADC值为（0．778±0．108）×10^-3mm2／s，PSA值为（28．055±28．880）μg／L；治疗后病灶ADC值显著升高为（1．068±0．187）×10。mm。／S（P〈o．05），PSA值显著降低为（6．265士13．203）μg／L（P〈0．05）；Pearson相关分析结果显示PC患者治疗前后ADC值与PSA均呈负相关（r=-0．677，P=0．001；r=-0．644，P=0．00）。结论：PC患者内分泌治疗后ADC值升高，与PSA水平呈负相关，DWI有望连续、定量、便捷地监测和评估PC疗效。

Study of DWI in prostate cancer therapeutic effect monitoring and the correlation between ADC values and PSA

Objectives：To explore the value of DWI in prostate cancer therapeutic effect monitoring and to analyze the correlation between ADC values and PSA. Methods：Forty-eight patients with pathologically proved prostate cancer who un- derwent conventional MRI and DWI examination before and after hormone therapy were enrolled in this study. Their PSA and ADC values were measured before and after treatment. Correlation between ADC values and PSA was analyzed. Results： Before and after treatment,the ADC values were （0. 778±0. 108） × 10-3mm2/s and （1. 068±0. 187） ×10-3mm2/s,respec- tively; PSA were （28. 055 ± 28. 880）μg/L and （6. 265 ± 13. 203）μg/L, respectively. Pearson correlation analysis showed that ADC values and PSA were negatively correlated before and after the treatment （r=- 0. 677, P= 0. 001;r=- 0. 644, P= 0. 001）. Conclusion：The ADC values of PC increase after treatment, and negatively correlate with PSA. Therefore, DWI may be a good method to guide clinical treatment and monitor therapeutic effect in prostate cancer.