DCE-MRI定量参数与前列腺癌Gleason评分及血清PSA相关性分析的价值
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摘要
目的探讨MRI动态增强定量参数K~(trans)、K_(ep)、V_e值与前列腺癌Gleason评分及血清PSA的相关性。方法回顾性搜集行前列腺MRI定量动态增强扫描,且扫描后2周内经穿刺活检证实为前列腺癌并行Gleason评分的患者共84例,所有患者测得K~(trans)、K_(ep)、V_e值及血清PSA值。穿刺标本进行Gleason评分,结果为2、3、4分的患者记为高分化组,5、6、7分记为中分化组,8、9、10分记为低分化组,3组的定量参数用单因素方差分析进行比较,血清PSA的差异采用Kruskal-Wallis检验。用Spearman相关分析,分析定量参数与Gleason评分及血清PSA的相关性,P<0.05为差异有统计学意义。结果高、中、低分化组的K~(trans)值分别为(0.652±0.063)min~(-1),(1.251±0.298)min~(-1),(1.631±0.571)min~(-1);K_(ep)值分别为(0.928±0.281)min~(-1),(1.803±0.575)min~(-1),(2.231±0.903)min~(-1);V_e值分别为(0.598±0.321),(0.777±0.230),(0.732±0.107);t PSA的中位数分别为13.85 ng/ml,45.89ng/ml,95.77 ng/ml;f PSA的中位数分别为0.59 ng/ml,4.74 ng/ml,12.63 ng/ml。K~(trans)、K_(ep)、V_e值与Gleason评分的相关系数分别为0.529、0.401、0.099,与t PSA的相关系数分别为0.484、0.455、0.131,与f PSA的相关系数分别为0.532、0.545、0.071。结论K~(trans)、K_(ep)值与Gleason评分及血清PSA具有相关性,对前列腺癌患者Gleason评分及病理分级有一定的预测价值及临床指导意义。
Objective To investigate the correlation between K~(trans),K_(ep)and V_evalues of MRI dynamic enhancement quantitative parameters and prostate cancer Gleason score and serum PSA.Methods A retrospective biopsy of prostate MRI was performed retrospectively.Prostate cancer was confirmed by biopsy within 2 weeks after the scan.A total of 84patients underwent Gleason score.K~(trans),K_(ep),V_eand serum PSA were measured in all patients.Gleason scores were obtained from the puncture specimens.Patients with scores of 2,3,and 4 were recorded as well-differentiated groups,5,6,and 7 were recorded as moderately differentiated groups,8,9,and 10 were recorded as poorly differentiated groups,and three groups were quantified.The parameters were compared by one-way analysis of variance,and the difference in serum PSA was tested by Kruskal-Wallis test.Spearman correlation analysis was used to analyze the correlation between quantitative parameters and Gleason score and serum PSA.P<0.05 was statistically significant.Results The K~(trans)values of the high,medium and low differentiation groups were(0.652±0.063)min~(-1),(1.251±0.298)min~(-1),(1.631±0.571)min~(-1),and the K_(ep)values were(0.928±0.281)min~(-1),(1.803±0.575)min~(-1),(2.231±0.903)min~(-1);V_evalues were(0.598±0.321),(0.777±0.230),(0.732±0.107);the median of t PSA was 13.85 ng/ml,45.89 ng/ml,95.77 ng/ml;the median of f PSA was 0.59 ng/ml,4.74 ng/ml,12.63 ng/ml,respectively.The correlation coefficients of K~(trans),K_(ep),V_eand Gleason scores were 0.529,0.401,and 0.099,respectively,and the correlation coefficients with t PSA were 0.484,0.455,and 0.131,respectively.The correlation coefficients with f PSA were 0.532,0.545,and0.071,respectively.Conclusion K~(trans)and K_(ep)values are correlated with Gleason score and serum PSA.They have cer-tain predictive value and clinical guiding significance for Gleason score and pathological grade of prostate cancer patients.
Objective To investigate the correlation between K~(trans),K_(ep)and V_evalues of MRI dynamic enhancement quantitative parameters and prostate cancer Gleason score and serum PSA.Methods A retrospective biopsy of prostate MRI was performed retrospectively.Prostate cancer was confirmed by biopsy within 2 weeks after the scan.A total of 84patients underwent Gleason score.K~(trans),K_(ep),V_eand serum PSA were measured in all patients.Gleason scores were obtained from the puncture specimens.Patients with scores of 2,3,and 4 were recorded as well-differentiated groups,5,6,and 7 were recorded as moderately differentiated groups,8,9,and 10 were recorded as poorly differentiated groups,and three groups were quantified.The parameters were compared by one-way analysis of variance,and the difference in serum PSA was tested by Kruskal-Wallis test.Spearman correlation analysis was used to analyze the correlation between quantitative parameters and Gleason score and serum PSA.P<0.05 was statistically significant.Results The K~(trans)values of the high,medium and low differentiation groups were(0.652±0.063)min~(-1),(1.251±0.298)min~(-1),(1.631±0.571)min~(-1),and the K_(ep)values were(0.928±0.281)min~(-1),(1.803±0.575)min~(-1),(2.231±0.903)min~(-1);V_evalues were(0.598±0.321),(0.777±0.230),(0.732±0.107);the median of t PSA was 13.85 ng/ml,45.89 ng/ml,95.77 ng/ml;the median of f PSA was 0.59 ng/ml,4.74 ng/ml,12.63 ng/ml,respectively.The correlation coefficients of K~(trans),K_(ep),V_eand Gleason scores were 0.529,0.401,and 0.099,respectively,and the correlation coefficients with t PSA were 0.484,0.455,and 0.131,respectively.The correlation coefficients with f PSA were 0.532,0.545,and0.071,respectively.Conclusion K~(trans)and K_(ep)values are correlated with Gleason score and serum PSA.They have cer-tain predictive value and clinical guiding significance for Gleason score and pathological grade of prostate cancer patients.
引文
1 Siegel RL,Miller KD. Cancer Statistics,2017[J]. CA Cancer J Clin,2017,67:7-30.
2 Partin AW,Kattan MW,Subong EN,et al. Combination of prostatespecific antigen,clinical stage,and Gleason score to predict pathological stage of localized prostate cancer A multi-institutional update[J]. JAMA,1997,277:1445-1451.
3 Zhang X,Quan X,Lu S,et al. The clinical value of dynamic contrast enhanced magnetic resonance imaging at 3. 0T to detect prostate cancer[J]. J Int Med Res,2014,42:1077-1084.
4 Khalifa F,Soliman A,El-Baz A,et al. Models and methods for analyzing DCE-MRI:A review[J]. Med Phys,2014,41:124301.
5 Peter A Humphrey. Gleason grading and prognostic factors in carcinoma of the prostate[J]. Modern Pathology,2004,17:292-306.
6 Egevad L,Delahunt B,Srigley JR. International Society of Urological Pathology(ISUP)grading of prostate cancer-An ISUP consensus on contemporary grading[J]. APMIS,2016,124:433-435.
7 Epstein JI,Amin MB,Reuter VE,et al. Contemporary Gleason Grading of Prostatic Carcinoma:An Update With Discussion on Practical Issues to Implement the 2014 International Society of Urological Pathology(ISUP)Consensus Conference on Gleason Grading of Prostatic Carcinoma[J]. Am J Surg Pathol,2017,41:e1-e7.
8 Epstein JI,Feng Z,Trock BJ,et al. Upgrading and downgrading of prostate cancer from biopsy to radical prostatectomy:incidence and predictive factors using the modified Gleason grading system and factoring in tertiary grades[J]. Eur Urol,2012,61:1019-1024.
9 白安胜,汪峰,贾军琪,等.前列腺增生症患者合并前列腺炎对血清PSA的影响[J].现代泌尿外科杂志,2012,17:177-179.
10 李春媚,陈敏,李飒英,等. 3. 0 T MR动态增强扫描定量分析诊断前列腺癌的初步研究[J].中华放射学杂志,2011,45:50-54.
11 Taylor JS,Tofts PS,Port R,et al. MR imaging of tumor microcirculation:promise for the new millennium[J]. J Magn Reson Imaging,1999,10:903-907.
12 Kalmuk J,Folaron M,Buchinger J,et al. Multimodal imaging guided preclinical trials of vascular targeting in prostate cancer[J]. Oncotarget,2015,6:24376-24392.
13 贾媛,王海宝,余永强,等. DCE-MRI对前列腺平台型强化灶的鉴别诊断价值[J].临床放射学杂志,2016,35:589-592.
14 Wang L,Mazaheri Y,Zhang J,et al. Assessment of biologic aggressiveness of prostate cancer:correlation of MR signal intensity with Gleason grade after radical prostatectomy[J]. Radiology,2008,246:168-176.
15 Rosenkrantz AB,Sabach A,Babb JS,et al. Prostate cancer:comparison of dynamic contrast-enhanced MRI techniques for localization of peripheral zone tumor[J]. AJR,2013,201:W471-478.
16 H9tker 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,2016,206:756-763.
2 Partin AW,Kattan MW,Subong EN,et al. Combination of prostatespecific antigen,clinical stage,and Gleason score to predict pathological stage of localized prostate cancer A multi-institutional update[J]. JAMA,1997,277:1445-1451.
3 Zhang X,Quan X,Lu S,et al. The clinical value of dynamic contrast enhanced magnetic resonance imaging at 3. 0T to detect prostate cancer[J]. J Int Med Res,2014,42:1077-1084.
4 Khalifa F,Soliman A,El-Baz A,et al. Models and methods for analyzing DCE-MRI:A review[J]. Med Phys,2014,41:124301.
5 Peter A Humphrey. Gleason grading and prognostic factors in carcinoma of the prostate[J]. Modern Pathology,2004,17:292-306.
6 Egevad L,Delahunt B,Srigley JR. International Society of Urological Pathology(ISUP)grading of prostate cancer-An ISUP consensus on contemporary grading[J]. APMIS,2016,124:433-435.
7 Epstein JI,Amin MB,Reuter VE,et al. Contemporary Gleason Grading of Prostatic Carcinoma:An Update With Discussion on Practical Issues to Implement the 2014 International Society of Urological Pathology(ISUP)Consensus Conference on Gleason Grading of Prostatic Carcinoma[J]. Am J Surg Pathol,2017,41:e1-e7.
8 Epstein JI,Feng Z,Trock BJ,et al. Upgrading and downgrading of prostate cancer from biopsy to radical prostatectomy:incidence and predictive factors using the modified Gleason grading system and factoring in tertiary grades[J]. Eur Urol,2012,61:1019-1024.
9 白安胜,汪峰,贾军琪,等.前列腺增生症患者合并前列腺炎对血清PSA的影响[J].现代泌尿外科杂志,2012,17:177-179.
10 李春媚,陈敏,李飒英,等. 3. 0 T MR动态增强扫描定量分析诊断前列腺癌的初步研究[J].中华放射学杂志,2011,45:50-54.
11 Taylor JS,Tofts PS,Port R,et al. MR imaging of tumor microcirculation:promise for the new millennium[J]. J Magn Reson Imaging,1999,10:903-907.
12 Kalmuk J,Folaron M,Buchinger J,et al. Multimodal imaging guided preclinical trials of vascular targeting in prostate cancer[J]. Oncotarget,2015,6:24376-24392.
13 贾媛,王海宝,余永强,等. DCE-MRI对前列腺平台型强化灶的鉴别诊断价值[J].临床放射学杂志,2016,35:589-592.
14 Wang L,Mazaheri Y,Zhang J,et al. Assessment of biologic aggressiveness of prostate cancer:correlation of MR signal intensity with Gleason grade after radical prostatectomy[J]. Radiology,2008,246:168-176.
15 Rosenkrantz AB,Sabach A,Babb JS,et al. Prostate cancer:comparison of dynamic contrast-enhanced MRI techniques for localization of peripheral zone tumor[J]. AJR,2013,201:W471-478.
16 H9tker 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,2016,206:756-763.