Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Department of Radiology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
Eur Radiol. 2019 Jan;29(1):411-421. doi: 10.1007/s00330-018-5602-0. Epub 2018 Jun 25.
To evaluate the correlation between tumour differentiation or stage of gallbladder cancer (GBC) and the apparent diffusion coefficient (ADC), as well as to assess whether ADC value can predict long-term disease-free survival (DFS) after surgery.
This retrospective study was approved by the institutional review board and the requirement for informed consent was waived. Between March 2008 and June 2016, 79 patients who underwent magnetic resonance (MR) imaging with diffusion-weighted image and subsequent surgery for GBC were included in this study. Correlations between quantitative ADC values and tumour differentiation or stage based on the American Joint Committee on Cancer (AJCC) were assessed using Spearman's correlation analysis. Prognostic factors for DFS were identified with multivariate Cox regression analysis using imaging and clinical characteristics.
All patients were classified as having well- (n = 18), moderately (n = 35) or poorly differentiated GBCs (n = 26). The ADC value of GBCs was significantly correlated with tumour differentiation and AJCC stage (p < 0.001 and p < 0.001, respectively). Sixty-nine patients were followed up for 2.0-92.4 months (median, 23.5 months). On multivariate analysis, the significant prognostic factor for DFS was not tumour differentiation or AJCC stage but a binary tumour ADC value (hazard ratio, 4.29; p = 0.009). DFS rates were significantly different according to the classification of tumour ADC value (cut-off value = 1.04 × 10 mm/s; p = 0.004).
The ADC value of GBCs was significantly correlated with tumour differentiation as well as AJCC stage. In addition, it predicted long-term outcomes after surgery in patients with GBC.
• ADC values of GBC and tumour differentiation were negatively correlated. • Lower ADC values of GBC were significantly correlated with higher tumour stage. • Tumour ADC value could be useful for risk stratification of GBC patients.
评估胆囊癌（GBC）肿瘤分化或分期与表观扩散系数（ADC）之间的相关性，并评估 ADC 值是否可预测手术后的长期无病生存（DFS）。
本回顾性研究经机构审查委员会批准，且豁免了知情同意书的要求。纳入 2008 年 3 月至 2016 年 6 月期间，因 GBC 行磁共振成像（MR）检查并随后行手术的 79 例患者。采用 Spearman 相关分析评估定量 ADC 值与基于美国癌症联合委员会（AJCC）的肿瘤分化或分期之间的相关性。使用影像学和临床特征的多变量 Cox 回归分析确定 DFS 的预后因素。
所有患者被分为高分化（n = 18）、中分化（n = 35）和低分化 GBC（n = 26）。GBC 的 ADC 值与肿瘤分化和 AJCC 分期显著相关（p < 0.001 和 p < 0.001）。69 例患者随访 2.0-92.4 个月（中位数 23.5 个月）。多变量分析显示，DFS 的显著预后因素不是肿瘤分化或 AJCC 分期，而是肿瘤 ADC 值的二分法（风险比 4.29；p = 0.009）。根据肿瘤 ADC 值的分类，DFS 率有显著差异（截断值 = 1.04×10 mm/s；p = 0.004）。
GBC 的 ADC 值与肿瘤分化以及 AJCC 分期显著相关。此外，它可预测 GBC 患者手术后的长期结局。
• GBC 的 ADC 值与肿瘤分化呈负相关。• GBC 的 ADC 值越低，肿瘤分期越高。• GBC 的肿瘤 ADC 值可用于 GBC 患者的风险分层。
