Liu Ying, Ye Zhaoxiang, Sun Haoran, Bai Renju
*Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy; and †Department of Radiology, General Hospital of Tianjin Medical University, Tianjin, China.
Int J Gynecol Cancer. 2015 Jul;25(6):1073-8. doi: 10.1097/IGC.0000000000000472.
This study aimed to investigate the application value of apparent diffusion coefficient (ADC) values in evaluating histological type as well as pathologic grade of uterine cervical cancer; and to investigate whether ADC values could reflect tumor cellular density.
Ninety-eight patients with histopathologically proven uterine cervical cancer were included in this study. Mean ADC value and minimum ADC value of the tumor were measured. Tumor cellular density was counted using colored multifunction imaging analyzing system.
Both mean ADC value and minimum ADC value of squamous cell carcinoma were significantly lower than that of adenocarcinoma (P = 0.001; P = 0.000). Using mean ADC criteria (≤0.965 × 10⁻³ mm/s²) and minimum ADC criteria (≤0.844 × 10⁻³ mm/s²), the sensitivity and specificity for differentiating squamous cell carcinoma from adenocarcinoma were 83.5% and 76.9%, and 77.6% and 92.3%, respectively. Receiver operating characteristic analysis revealed that there was no statistically significant difference in the Az values between them (P = 0.990). Tumor cellular density, mean ADC value, and minimum ADC value of different pathological grade varied significantly (P = 0.000, P = 0.000, P = 0.000). There was a significant positive linear correlation between tumor cellular density and pathological grade of tumor (P = 0.000). Both mean ADC value and minimum ADC value correlated negatively with cellular density (P = 0.000, P = 0.000) and the pathological grade of tumor (P = 0.000, P = 0.000). Comparisons of correlation coefficients showed no significant differences (P = 0.656, P = 0.631).
Diffusion-weighted magnetic resonance imaging has a potential ability to indicate the histologic type of uterine cervical cancer. Apparent diffusion coefficient measurements of uterine cervical cancer can represent tumor cellular density, thus providing a new method for evaluating the pathological grade of tumor.
本研究旨在探讨表观扩散系数（ADC）值在评估宫颈癌组织学类型及病理分级中的应用价值；并研究ADC值是否能反映肿瘤细胞密度。
本研究纳入98例经组织病理学证实的宫颈癌患者。测量肿瘤的平均ADC值和最小ADC值。使用彩色多功能成像分析系统计算肿瘤细胞密度。
鳞状细胞癌的平均ADC值和最小ADC值均显著低于腺癌（P = 0.001；P = 0.000）。采用平均ADC标准（≤0.965×10⁻³mm/s²）和最小ADC标准（≤0.844×10⁻³mm/s²），鉴别鳞状细胞癌与腺癌的敏感度和特异度分别为83.5%和76.9%，以及77.6%和92.3%。受试者工作特征分析显示，两者的Az值无统计学显著差异（P = 0.990）。不同病理分级的肿瘤细胞密度、平均ADC值和最小ADC值差异有统计学意义（P = 0.000，P = 0.000，P = 0.000）。肿瘤细胞密度与肿瘤病理分级之间存在显著的正线性相关（P = 0.000）。平均ADC值和最小ADC值均与细胞密度呈负相关（P = 0.000，P = 0.000）以及与肿瘤病理分级呈负相关（P = 0.000，P = 0.000）。相关系数比较无显著差异（P = 0.656，P = 0.631）。
扩散加权磁共振成像具有指示宫颈癌组织学类型的潜在能力。宫颈癌的表观扩散系数测量可代表肿瘤细胞密度，从而为评估肿瘤病理分级提供一种新方法。
