摘要
目的:分析磁共振扩散加权成像(DWI)测量的表观扩散系数(ADC)值与乳腺浸润性导管癌(IDC)患者预后的关系,探讨ADC值预测乳腺癌复发和转移的价值。方法:回顾性分析147例IDC患者的临床及影像资料,根据随访情况分为复发组(34例)和无复发组(114例),比较两组患者的ADC值差异,同时分析影响患者复发转移的相关危险因素。结果:复发组与无复发组的的平均ADC值分别为(0.84±0.15)、(0.92±0.17)×10^(-3) mm^(2)/s,差异有统计学意义(P=0.015);两组在ADC值分布上差异亦有统计学意义(P=0.018)。年龄<35岁患者的中位ADC值低于年龄≥35岁患者(P=0.029),直径2~5 cm肿瘤的中位ADC值低于肿瘤直径>5 cm者(P=0.040),ER阳性肿瘤的中位ADC值低于ER阴性者(P=0.049)。ROC曲线分析结果显示,ADC值取0.907×10^(-3)mm ^(2)/s(≤0.907×10^(-3)mm ^(2)/s具有复发和转移风险)是最好的预测复发转移截断值,具有最高的敏感度(82.35%)和较高的特异度(47.79%),ROC曲线下面积为0.634。ADC值越高,发生复发转移的风险越小(HR:0.047,95%CI:0.005~0.049,P=0.011)。结论:ADC值对预测乳腺癌复发和转移有一定价值,可为临床预测远期预后提供参考依据。
Objective:The aim of the study was to analyze the relationship between the apparent diffusion coefficient(ADC)measured by diffusion weighted magnetic resonance imaging(DWI)and the prognosis of patients with invasive ductal carcinoma of the breast(IDC),and to explore the value of ADC value in predicting breast cancer recurrence and metastasis.Methods:The clinical and imaging data of 147 IDC patients were retrospectively analyzed.According to the follow-up results,they were divided into recurrent group(34 cases)and non-recurrent group(114 cases),the difference in ADC value between the two groups were compared,and the related risk factors affecting the recurrence and metastasis of the patients were analyzed.Results:The mean ADC value of the recurrent group was lower than that of the non-recurrent group(P=0.015),(0.84±0.15)×10^(-3) mm^(2)vs(92±0.17)×10^(-3) mm^(2).There was also significant difference in ADC value distribution between the two groups(P=0.018).The median ADC value of patients with age<35 years old was lower than that of patients with age≥35 years old(P=0.029);the median ADC value of tumors with diameter of 2 to 5cm was lower than that of tumors with diameter of>5cm(P=0.040);the median ADC value of ER-positive tumors was lower than that of ER-negative tumors(P=0.049).ROC curve analysis results showed that ADC value of 0.907×10^(-3) mm^(2)/s(≤0.907×10^(-3) mm^(2)indicated the recurrence and metastasis risk)was the best cutoff value for predicting recurrence and metastasis,with the highest sensitivity(82.35%)and high specificity(47.79%).The area under the ROC was 0.634.The higher the ADC value,the lower the risk of recurrence and metastasis(HR:0.047,95%CI:0.005~0.049,P=0.011).Conclusion:ADC value has certain value in predicting breast cancer recurrence and metastasis,and can provide a reference for clinical prediction of long-term prognosis.
作者
胡善林
罗建芳
聂云凤
莫钦国
HU Shan-lin;LUO Jian-fang;NIE Yun-feng(Department of general surgery,Liuzhou People'Hospital,Guangxi 545006,China)
出处
《放射学实践》
CSCD
北大核心
2021年第5期601-605,共5页
Radiologic Practice
基金
广西自然科学基金资助项目(2017GXNSFAA198088)。
关键词
乳腺癌
预后
复发
磁共振成像
扩散加权成像
表观扩散系数
Breast cancer
Prognosis
Relapse
Magnetic resonance imaging
Diffusion weighted imaging
Apparent diffusion coefficient
