DCE-MRI定量参数对前列腺癌内分泌治疗的疗效评价

目的:回顾性分析前列腺癌(PCa)内分泌治疗前后DCE-MRI定量参数的变化,探讨DCE-MRI定量参数作为分析指标在用于PCa内分泌治疗后疗效监测的价值.方法:收集经病理学证实的33例PCa患者的临床和影像资料.测量定量参数:转运常数(Ktrans)、血管外细胞外间隙体积百分数(Ve)和速率常数(Kep)在内分泌治疗前后癌区的各参数值和血清PSA水平,对前后间参数变化的差异作统计学分析,并探讨DCE-MRI定量参数变化与PSA值变化之间的相关性.结果:治疗前癌区的Ktrans(3.2502±1.46)×10-3 min-1、Kep(2.3341±1.59)×10-3 min-1、Ve 1.1.7475±0.87、PSA (59.9054±37.15)μg/L,治疗后癌区的Ktrans(2.1873±1.19)×10-3min-1、Kep(1.0325±0.68)×10-3min-1、Ve2.0512±0.75、PSA (2.4831±3.93)μg/L;,其中癌区Ktrans、Kep值、PSA值在治疗前后间的差异均有统计学意义(P＜0.05),而Ve在治疗前后间的差异没有统计学意义(P＞0.05).Spearman相关分析显示癌区治疗前后DCE-MRI的参数变化与PSA值变化无相关性(P＞0.05).结论:DCE-MRI的定量参数Ktrans、Kep在PCa内分泌治疗后发生变化,可用于临床PCa内分泌治疗的疗效监测,可作为临床PCa疗效检测指标PSA的补充.

The evaluation of DCE-MRI quantitative parameters on the efficacy of endocrine therapy in prostate cancer

Objective:The quantitative parameters of DCE-MRI before and after endocrine therapy were retrospective ly analyzed,aiming to evaluate the value of these parameters considered as an index of analysis to monitor the endocrine therapy effect to prostate cancer (PCa),and to explore the correlation between the parameters with serum PSA level.Methods:The clinical and imaging data of 33 patients with pathologically confirmed PCa were collected.The parameters such as Ktrans,Ve and Kep and the serum PSA level were measured and obtained before and after endocrine therapy.The difference between the parameters before and after was analyzed for statistical analysis.Results:Before treatment,Ktrans value in the cancer area was (3.2502±1.46)×10-3min-1,Kep=(2.3341±1.59)×10-3min-1,and Ve=1.1.7475 ± 0.87.PSA was (59.9054±37.15)μg/L.After treatment,Ktrans=(2.1873 ± 1.19) × 10 3min-1,Kep=(1.0325±0.68) ×10-3min-1,Ve=2.0512±0.75,PSA=(2.4831±3.93)μg/L;Thedifferenceof Ktrans,Kep and PSA was statistically significant (P＜0.05),but the difference of Ve had no significant statistical difference (P＞0.05).Spearman correlation analy sis showed that there was no significant correlation between DCE MRI parameters and PSA values before and after treat ment (P＞0.05).Conclusion:The changes of quantitative parameters of DCE-MRI Ktrans,Kep in PCa after endocrine ther apycan be used as a clinical index and supplement to serum PSA level for evaluating clinical endocrine therapy efficacy in prostate carcinoma for efficacy evaluation.