穿刺标本Gleason评分及肿瘤百分比与前列腺癌表观弥散系数的相关性研究
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摘要
目的探讨前列腺癌穿刺标本中肿瘤累及组织程度(百分比)与病灶ADC值及Gleason评分的关系。方法41例病理证实前列腺癌患者行弥散加权成像(diffusion weighted imaging,DWI)检查,以穿刺位置为单位,测量所有前列腺癌的ADC值和穿刺标本的肿瘤百分比并进行比较,应用相关分析肿瘤百分比与前列腺癌ADC值及Gleason评分的相关关系。结果统计共114处穿刺阳性位置的数据,平均ADC值为(0. 91±0. 16)×10-3mm2/s,穿刺标本肿瘤百分比平均值为(64. 6+31. 7)%。全部前列腺癌样本ADC值与Gleason评分呈负相关关系(R2=-0. 41,P <0. 05),累及组织70%~100%组前列腺癌ADC值亦与Gleason评分呈负相关(R2=-0. 56,P <0. 05),但其余各组无显著相关关系。前列腺癌ADC值与累及组织百分比亦呈负相关关系(R2=-0. 71,P <0. 05),且相关度高于与Gleason评分的相关性。结论前列腺癌ADC值同时受到Gleason评分及肿瘤百分比影响,对Gleason评分预测价值有限。基于穿刺标本肿瘤百分比的前列腺癌ADC值对于Gleason评分预测具有一定的价值。
Objective To explore the relationship among the perentage of tumor invoivement in needle biopsy tissues,AD value and Gleason score. Methods 41 patients with prostate cancer that identified by pathology underwent diffusion weighted imaging(diffusion weighted imaging,DWI). Results The data shows that a total of 114 cases are reveal positive value during needle biopsy,the average value of ADC is(0. 91 ± 0. 16) × 10-3 mm2/s,the average of needle biopsy tumor percentage is(64. 6 ±31. 7) %. All the ADC values from prostate cancer samples display a negative correlation with Gleason score(R2=-0. 41,P <0. 05). The ADC value in the group involved 70% ~ 100% show a negative correlation with Gleason score as well. However,other groups do not have a remarkable correlation with Gleason score. Prostate cancer's ADC value also has a negative correlation with tumor involvement percentage(R2=-0,71,P < 0. 05),and the correlation is higher than Gleason score. Conclusion The prostate cancer's ADC value can be influenced by Gleason score and tumor percentage simultaneously. It sets a limit predictive value of Gleason score. However,the needle biopsy of tumor percentage has a better predictive value to Gleason score.
Objective To explore the relationship among the perentage of tumor invoivement in needle biopsy tissues,AD value and Gleason score. Methods 41 patients with prostate cancer that identified by pathology underwent diffusion weighted imaging(diffusion weighted imaging,DWI). Results The data shows that a total of 114 cases are reveal positive value during needle biopsy,the average value of ADC is(0. 91 ± 0. 16) × 10-3 mm2/s,the average of needle biopsy tumor percentage is(64. 6 ±31. 7) %. All the ADC values from prostate cancer samples display a negative correlation with Gleason score(R2=-0. 41,P <0. 05). The ADC value in the group involved 70% ~ 100% show a negative correlation with Gleason score as well. However,other groups do not have a remarkable correlation with Gleason score. Prostate cancer's ADC value also has a negative correlation with tumor involvement percentage(R2=-0,71,P < 0. 05),and the correlation is higher than Gleason score. Conclusion The prostate cancer's ADC value can be influenced by Gleason score and tumor percentage simultaneously. It sets a limit predictive value of Gleason score. However,the needle biopsy of tumor percentage has a better predictive value to Gleason score.
引文
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[12] De Visschere PJ,Naesens L,Libbrecht L,et al. What kind of prostate cancers do we miss on multiparametric magnetic resonance imaging?[J]. Eur Radiol,2016,26(4):1098-1107.
[13] Donati OF,Mazaheri Y,Afaq A,et al. Prostate cancer aggressiveness:assessment with whole-lesion histogram analysis of the apparent diffusion coefficient[J]. Radiology,2014,271(1):143-152.
[2] Tamada T,Sone T,Jo Y,et al. Apparent diffusion coefficient values in peripheral and transition zones of the prostate:comparison between normal and malignant prostatic tissues and correlation with histologic grade[J]. J Magn Reson Imaging,2008,28(3):720-726.
[3] Woodfield CA,Tung GA,Grand DJ,et al. Diffusion-weighted MRI of peripheral zone prostate cancer:comparison of tumor apparent diffusion coefficient with Gleason score and percentage of tumor on core biopsy[J]. AJR,2010,194(4):316-322.
[4] Hotker AM,Mazaheri Y,Aras O,et al. Assessment of prostate cancer aggressiveness by use of the combination of quantitative DWI and dynamic contrast-enhanced MRI[J]. AJR,2016,206(4):756-763.
[5] Kim CK,Park BK,Lee HM,et al. Value of diffusion-weighted imaging for the prediction of prostate cancer location at 3 T using a phased-array coil:preliminary results[J]. Invest Radiol,2007,42(12):842-847.
[6] Wang XZ,Wang B,Gao ZQ,et al. Diffusion-weighted imaging of prostate cancer:correlation between apparent diffusion coefficient values and tumor proliferation[J]. J Magn Reson Imaging,2009,29(6):1360-1366.
[7]汪朔,谢立平,沈华锋,等. 346例前列腺癌的Gleason评分分布特征及其与临床分期的关系[J].中华男科学杂志,2006,12(8):689-692.
[8]程亮,王曦,朱扬丽,等.前列腺癌Gleason分级目前进展的剖析[J].中华病理学杂志,2011,40(9):577-580.
[9] Gibbs P,Pickles MD,Turnbull LW. Diffusion imaging of the prostate at 3. 0 tesla[J]. Invest Radiol,2006,41(2):185-188.
[10] Kim CK,Park BK,Han JJ,et al. Diffusion-weighted imaging of the prostate at 3 T for differentiation of malignant and benign tissue in transition and peripheral zones:preliminary results[J]. J Comput Assist Tomogr,2007,31(3):449-454.
[11] Borren A,Moman MR,Groenendaal G,et al. Why prostate tumour delineation based on apparent diffusion coefficient is challenging:an exploration of the tissue microanatomy[J]. 2013,52:1629-1636.
[12] De Visschere PJ,Naesens L,Libbrecht L,et al. What kind of prostate cancers do we miss on multiparametric magnetic resonance imaging?[J]. Eur Radiol,2016,26(4):1098-1107.
[13] Donati OF,Mazaheri Y,Afaq A,et al. Prostate cancer aggressiveness:assessment with whole-lesion histogram analysis of the apparent diffusion coefficient[J]. Radiology,2014,271(1):143-152.