Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Gynecol Oncol. 2012 Feb;124(2):335-9. doi: 10.1016/j.ygyno.2011.10.014. Epub 2011 Oct 18.
The purpose of this study was to evaluate whether preoperative measurements of the minimum apparent diffusion coefficient (ADCmin) on magnetic resonance imaging (MRI) and the tumor marker CA125 are correlated with the clinical characteristics and prognosis of patients with endometrial cancer.
The distribution of cases that scored positive for each of the biological parameters examined and the correlations with the ADCmin of the primary tumor and the serum tumor marker CA125 were examined for 111 patients with preoperative assessment of primary endometrial cancer.
There were significant correlations between the ADCmin of the primary tumor and the FIGO stage (P=0.001), depth of myometrial invasion (P<0.001), cervical involvement (P=0.003), lymph node metastasis (P=0.027), ovarian metastasis (P<0.001), peritoneal cytology (P=0.027) and tumor maximum size (P<0.001). The disease-free survival (DFS) rate of patients with high serum CA125 was significantly lower than that of patients with low serum CA125 (P=0.0395). The DFS rate of patients with a low ADCmin of the primary tumor was significantly lower than that of patients with a high ADCmin of the primary tumor (P<0.001). In particular, the ADCmin of the primary tumor was an independent factor for disease recurrence in a multivariate analysis (P=0.019).
The present findings indicate that a low preoperative ADCmin of the primary tumor is an important predictive factor for identifying endometrial cancer patients with a risk of disease recurrence.
本研究旨在评估磁共振成像(MRI)上最小表观扩散系数(ADCmin)术前测量值和肿瘤标志物 CA125 是否与子宫内膜癌患者的临床特征和预后相关。
对 111 例术前评估原发性子宫内膜癌患者的生物标志物检查结果阳性分布情况及其与原发性肿瘤 ADCmin 和血清肿瘤标志物 CA125 的相关性进行了分析。
原发性肿瘤 ADCmin 与 FIGO 分期(P=0.001)、肌层浸润深度(P<0.001)、宫颈受累(P=0.003)、淋巴结转移(P=0.027)、卵巢转移(P<0.001)、腹腔细胞学检查(P=0.027)和肿瘤最大直径(P<0.001)均存在显著相关性。血清 CA125 水平高的患者无疾病生存率(DFS)明显低于血清 CA125 水平低的患者(P=0.0395)。原发性肿瘤 ADCmin 低的患者 DFS 率明显低于原发性肿瘤 ADCmin 高的患者(P<0.001)。特别是,在多因素分析中,原发性肿瘤的 ADCmin 是疾病复发的独立因素(P=0.019)。
本研究结果表明,术前原发性肿瘤 ADCmin 较低是识别具有疾病复发风险的子宫内膜癌患者的重要预测因素。