MR扩散加权成像表观扩散系数与乳腺浸润性导管癌病理分级相关性研究

摘要

目的：探讨表观扩散系数(apparent diffusion coefficient，ADC)值与乳腺癌病理分级是否具有相关性。材料与方法回顾性分析经病理证实并具有病理分级的66例乳腺浸润性导管癌，对病灶进行ADC值测量，取感兴趣区的ADC均值ADCmean及最小值ADCmin。依据治疗及预后(病理分级、淋巴结情况)分为病理分级、预后复发两组，采用SPSS19.0(One-way ANOVA、LSD检验、Spearman等级秩相关)进行统计学分析。结果 ADCmean值在病理分级1、2、3组内均数分别为0.993×10-3 mm2/s、0.969×10-3 mm2/s、0.926×10-3 mm2/s，ADCmin值的均数分别为0.849×10-3 mm2/s、0.660×10-3 mm2/s、0.535×10-3 mm2/s。ADCmean值在预后复发A、B、C组内均数分别为1.014×10-3 mm2/s、1.029×10-3 mm2/s、0.919×10-3 mm2/s， ADCmin值的均数分别为0.918×10-3 mm2/s、0.750×10-3 mm2/s、0.540×10-3 mm2/s。 ADCmean与病理分级、预后复发分组间不具有相关性，ADCmin与病理分级组(r=-0.615，P=0.000)、预后复发组(r=-0.754，P=0.000)间呈负相关。结论 ADCmin值可以作为对乳腺癌术前治疗方案的制定及预后复发进行初步评估的一种指标。%AbstractObjectives:The aim of this study was to evaluate the correlation between apparent diffusion coefficient (ADC) values and histopathologic classification of breast invasive ductal cancer.Materials and Methods:Sixty-six cases of breast cancer conformed by histopathology with histopathologic classiifcation were involved in this retrospective study. The ADC values of lesions were measured and the mean (ADCmean) and minimum (ADCmin) of regions of interest (ROIs) were taken. The cases were divided into two groups, histopathologic classification and prognostic recurrence, according to the treatment and prognosis (histopathologic classification, lymph node status). The correlation was analyzed by using SPSS19.0 software (one-way ANOVA, LSD test andSpearman’ rank correlation coefifcient method).Results:There were two groups, histopathologic classiifcation group and prognostic recurrence group, which were divided three stages, respectively. ADCmean were 0.993×10-3 mm2/s、0.969×10-3mm2/s、0.926×10-3mm2/s, respectively, whileADCmin were0.849×10-3 mm2/s、0.660×10-3 mm2/s、0.535×10-3 mm2/s in the former group, respectively, ADCmean were1.014×10-3 mm2/s、1.029×10-3 mm2/s、0.919×10-3 mm2/s, respectively, while ADCmin were 0.918×10-3 mm2/s、0.750×10-3 mm2/s、0.540×10-3 mm2/s in the latter group, respectively. ADCmean had no correlation with either histopathologic classification group or prognostic recurrence group. There was negative correlation between ADCmin and histopathologic classification group (r=-0.615,P=0.000) as well as prognostic recurrence group (r=-0.754,P=0.000).Conclusions:The ADCmin can be considered as an indicator of the development of medical plan before breast cancer surgery and the preliminary assessment of prognostic recurrence.