Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China.
Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University (SYSU), No 600, Tianhe Road, Guangzhou, Guangdong, 510630,, People's Republic of China.
BMC Cancer. 2019 May 17;19(1):470. doi: 10.1186/s12885-019-5684-3.
To explore prognostic value of the pre-treatment primary lesion apparent diffusion coefficient (ADC) in locoregionally advanced nasopharyngeal carcinoma (LA-NPC).
A total of 843 patients with newly diagnosed LA-NPC were enrolled from January 2011 to April 2014 and divided into two groups based on ADC values: the low-ADC group and high-ADC group. The 3-year local relapse-free survival (LRFS), distant metastasis free survival (DMFS), disease-free survival (DFS) and overall survival (OS) rates between two groups were compared using Kaplan-Meier curve, and Cox regression analyses were performed to test prognostic value of the pretreatment ADC in LA-NPC.
The cut-off value of the pretreatment ADC for predicting local relapse was 784.5 × 10 mm/s (AUC [area under curve] = 0.604; sensitivity = 0.640; specificity = 0.574), thus patients were divided into low-ADC (< 784.5 × 10; n = 473) group and high-ADC (≥784.5 × 10; n = 370) group. The low-ADC group had significantly higher 3-year LRFS rate and DFS rate than the high-ADC group (LRFS: 96.2% vs. 91.4%, P = 0.003; DFS: 81.4% vs. 73.0%, P = 0.0056). Multivariate analysis showed that the pretreatment ADC is an independent prognostic factor for LRFS (HR, 2.04; 95% CI, 1.13-3.66; P = 0.017) and DFS (HR, 1.41; 95% CI, 1.04-1.89; P = 0.024).
The pretreatment ADC of the primary lesion is an independent prognostic factor for LRFS and DFS in LA-NPC patients.
探讨局部晚期鼻咽癌（LA-NPC）患者治疗前原发肿瘤表观扩散系数（ADC）的预后价值。
回顾性分析 2011 年 1 月至 2014 年 4 月期间新诊断为 LA-NPC 的 843 例患者，根据 ADC 值将其分为低 ADC 组和高 ADC 组。采用 Kaplan-Meier 曲线比较两组患者 3 年局部无复发生存率（LRFS）、无远处转移生存率（DMFS）、无病生存率（DFS）和总生存率（OS），采用 Cox 回归分析评估治疗前 ADC 对 LA-NPC 的预后价值。
预测局部复发的 ADC 截断值为 784.5×10mm/s（AUC [曲线下面积] = 0.604；敏感性 = 0.640；特异性 = 0.574），因此将患者分为低 ADC（<784.5×10mm/s；n=473）组和高 ADC（≥784.5×10mm/s；n=370）组。低 ADC 组的 3 年 LRFS 率和 DFS 率明显高于高 ADC 组（LRFS：96.2% vs. 91.4%，P=0.003；DFS：81.4% vs. 73.0%，P=0.0056）。多因素分析显示，治疗前 ADC 是 LRFS（HR，2.04；95%CI，1.13-3.66；P=0.017）和 DFS（HR，1.41；95%CI，1.04-1.89；P=0.024）的独立预后因素。
LA-NPC 患者治疗前原发肿瘤 ADC 值是 LRFS 和 DFS 的独立预后因素。
