胰腺癌放射治疗中表观扩散系数（ADC）与病理治疗反应的相关性

Correlation of ADC With Pathological Treatment Response for Radiation Therapy of Pancreatic Cancer.

作者信息

Dalah Entesar, Erickson Beth, Oshima Kiyoko, Schott Diane, Hall William A, Paulson Eric, Tai An, Knechtges Paul, Li X Allen

机构信息

Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Medical Diagnostic Imaging, College of Health Science, University of Sharjah, UAE.

Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.

出版信息

Transl Oncol. 2018 Apr;11(2):391-398. doi: 10.1016/j.tranon.2018.01.018. Epub 2018 Feb 20.

PURPOSE

To investigate the feasibility of using apparent diffusion coefficient (ADC) to assesspathological treatment response in pancreatic ductal adenocarcinoma (PDAC) following neoadjuvant chemoradiation (nCR).

MATERIALS/METHODS: MRI and pathological data collected for 25patients with resectable and borderline resectable PDAC following nCR were retrospectively analyzed. Pre- and post-nCR mean ADC values in the tumors were compared using Wilcoxon matched pairs test. Correlation of pathological treatment response and ADC values was assessed using Pearson's correlation coefficient test and receiver-operating-curve (ROC) analysis.

RESULTS

The average mean and standard deviation (SD) of the ADC values for all the patients analyzed were significantly higher in post-nCR (1.667±0.161×10) compared with those prior to nCR (1.395±0.136×10 mm/sec), (P<0.05). The mean ADC values after nCR were significantly correlated with the pathological responses (r=-0.5172); P=0.02. The area under the curve (AUC) of the ADC values for differentiating G1, G2 and G3 pathological responses, using ROC analysis, was found to be 0.6310 and P=0.03.

CONCLUSION

Changes of pre- and post-treatment ADC values significantly correlated with pathological treatment response for PDAC patients treated with chemoradiation therapy, indicating that the ADC could be used to assesstreatment response for PDAC.

目的

探讨在新辅助放化疗（nCR）后使用表观扩散系数（ADC）评估胰腺导管腺癌（PDAC）病理治疗反应的可行性。

材料/方法：回顾性分析25例nCR后可切除和交界可切除PDAC患者的MRI和病理数据。使用Wilcoxon配对检验比较肿瘤在nCR前后的平均ADC值。使用Pearson相关系数检验和受试者操作特征曲线（ROC）分析评估病理治疗反应与ADC值的相关性。

结果

所有分析患者的ADC值，nCR后的平均均值和标准差（SD）（1.667±0.161×10）显著高于nCR前（1.395±0.136×10 mm²/sec），（P<0.05）。nCR后的平均ADC值与病理反应显著相关（r=-0.5172）；P=0.02。使用ROC分析，ADC值区分G1、G2和G3病理反应的曲线下面积（AUC）为0.6310，P=0.03。