Zhang Si-Cong, Zhou Shui-Hong, Shang De-Sheng, Bao Yang-Yang, Ruan Ling-Xiang, Wu Ting-Ting
Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
Department of Otolaryngology, People's Hospital of Cixi City, Cixi, Zhejiang 315300, P.R. China.
Oncol Lett. 2018 Apr;15(4):5533-5544. doi: 10.3892/ol.2018.8053. Epub 2018 Feb 14.
The aim of the present study was to assess the role of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficient (ADC) values in hypopharyngeal carcinoma. A total of 40 hypopharyngeal carcinoma tissues and 15 benign lesion tissues were retrospectively analyzed. DWI, and T1- and T2-weighted magnetic resonance imaging (MRI) was performed. The sensitivity, specificity and accuracy of conventional MRI were 97.5, 66.7, and 89.1%, respectively. The mean ADC value [diffusion sensitive factor (b)=1,000× sec/mm) for hypopharyngeal carcinomas was (1.0285±0.0328)×10 mm/sec, which was significantly lower than the mean ADC value for benign lesions [(1.5333±0.1061)×10 mm/sec; P<0.001]. Receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) was 0.921 while the optimal threshold for the cut-off point of the ADC was 1.075×10 mm/sec. The mean ADC value of the metastatic nodes was (0.9184±0.0538)×10 mm/sec, lower than the mean value for the benign nodes [(1.2538±0.1145)×10 mm/sec; P=0.005]. Two groups were created according to the mean of the ADC value of hypopharyngeal carcinomas [≤(1.0285±0.0328)×10 mm/sec vs. >(1.0285±0.0328)×10 mm/sec]. The 2-year survival rates of the two groups were 55.6 and 100.0%, respectively (P=0.024). ADC values may aid in distinguishing hypopharyngeal carcinomas from benign lesions and differentiating metastatic lymph nodes of hypopharyngeal squamous cell carcinomas from reactive cervical lymph nodes. In conclusion, mean ADC values may be useful prognostic factors in univariate analysis of hypopharyngeal carcinoma.
本研究的目的是评估扩散加权磁共振成像（DWI）及表观扩散系数（ADC）值在下咽癌中的作用。回顾性分析了40例下咽癌组织和15例良性病变组织。进行了DWI以及T1加权和T2加权磁共振成像（MRI）检查。传统MRI的敏感性、特异性和准确性分别为97.5%、66.7%和89.1%。下咽癌的平均ADC值[扩散敏感因子（b）=1000×秒/毫米]为（1.0285±0.0328）×10⁻³毫米²/秒，显著低于良性病变的平均ADC值[（1.5333±0.1061）×10⁻³毫米²/秒；P<0.001]。受试者操作特征（ROC）曲线分析显示，曲线下面积（AUC）为0.921，而ADC截断点的最佳阈值为1.075×10⁻³毫米²/秒。转移淋巴结的平均ADC值为（0.9184±0.0538）×10⁻³毫米²/秒，低于良性淋巴结的平均值[（1.2538±0.1145）×10⁻³毫米²/秒；P=0.005]。根据下咽癌ADC值的平均值[≤（1.0285±0.0328）×10⁻³毫米²/秒与>（1.0285±0.0328）×10⁻³毫米²/秒]分为两组。两组的2年生存率分别为55.6%和100.0%（P=0.024）。ADC值可能有助于区分下咽癌与良性病变，并鉴别下咽鳞状细胞癌的转移淋巴结与反应性颈部淋巴结。总之，平均ADC值可能是下咽癌单因素分析中有用的预后因素。
