扩散加权成像和临床分期在鼻咽癌预后评估中的价值

The value of diffusion-weighted imaging and clinical staging in the prognostic evaluation of nasopharyngeal carcinoma

摘要:

目的 探讨扩散加权成像（diffusion-weighted imaging，DWI）测量的表观扩散系数值（apparent diffusion coefficient，ADC）和鼻咽癌2017分期在预后评估中的价值。方法 回顾性分析90例鼻咽癌患者的临床和影像资料，评估原发肿瘤ADC值与鼻咽癌分期的相关性。放化疗后进行随访，患者的中位随访时间为54个月（5-90个月），根据疾病进展情况分为疾病进展组(29例)和非进展组(61例)，探讨影响鼻咽癌预后的因素。结果I+II期患者原发肿瘤ADC值显著高于III期和IVa期患者（P＜0.05）。T1期、T2期患者原发肿瘤ADC值显著高于T4期患者（P＜0.05）。多因素分析显示， IVa期较I-III期发生疾病进展的风险更大（OR=3.497， P=0.001）。结论 鼻咽癌原发肿瘤ADC值与我国鼻咽癌2017分期相关。临床分期是鼻咽癌预后的预测因子。

Abstract:

Objective To explore the value of the apparent diffusion coefficient measured by diffusion-weighted imaging and the 2017 staging of nasopharyngeal carcinoma in prognostic evaluation. Methods The clinical and imaging data of 90 Nasopharyngeal carcinoma patients were retrospectively analyzed. The correlation between DWI parameters of primary tumor and T stages，N stages and clinical stages were evaluated. The median follow-up time was 54 months（5-90 months）.According to the disease progression after chemoradiotherapy，they were divided into progressive group（29 cases） and non-progressive group（61 cases）. Results The ADC values of primary tumor of I+II stage were significantly higher than III and IVa stage（P＜0.05）.The ADC values of T1 and T2 stage were significantly higher than T4 stage（P＜0.05）. Multivariate Cox analysis showed that the risk of disease progression was higer in IVa stage than in I-III stage（OR=3.497， P=0.001）. Conclusion ADC value of primary tumor is correlated with 2017 stage of Nasopharyngeal carcinoma in China. Clinical stage is prognostic factor for disease progression.