Department of Medical Imaging, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, China.
Technol Cancer Res Treat. 2019 Jan-Dec;18:1533033819892254. doi: 10.1177/1533033819892254.
OBJECTIVE: To investigate the application value of apparent diffusion coefficient value in the pathological type, histologic grade, and presence of lymph node metastases of esophageal carcinoma. MATERIALS AND METHODS: Eighty-six patients with pathologically confirmed esophageal carcinoma were divided into different groups according to pathological type, histological grade, and lymph node status. All patients underwent conventional magnetic resonance imaging and diffusion-weighted imaging scan, and apparent diffusion coefficient values of tumors were measured. Independent sample test and 1-way variance were used to compare the difference of apparent diffusion coefficient value in different pathological types, histologic grades, and lymph node status. Correlation between the apparent diffusion coefficient value and the histologic grade was evaluated using Spearman rank correlation test. Receiver operating characteristic curve of apparent diffusion coefficient value was generated to evaluate the differential diagnostic efficiency of poorly and well/moderately differentiated esophageal carcinoma. RESULTS: No significant difference was observed in apparent diffusion coefficient value between esophageal squamous cell carcinoma and adenocarcinoma and in patients between those with and without lymph node metastases ( > .05). The differences of apparent diffusion coefficient value were statistically significant between different histologic grades of esophageal carcinoma ( < .05). The apparent diffusion coefficient value was positively correlated with histologic grade (s = 0.802). The apparent diffusion coefficient value ≤1.25 × 10 mm/s as the cutoff value for diagnosis of poorly differentiated esophageal carcinoma with the sensitivity of 84.3%, and the specificity was 94.3%. CONCLUSIONS: The performance of apparent diffusion coefficient value was contributing to predict the histologic grade of esophageal carcinoma, which might increase lesions characterization before choosing the best therapeutic alternative. However, they do not correlate with pathological type and the presence of lymph node metastases of esophageal carcinoma.
目的：探讨表观扩散系数值在食管癌病理类型、组织学分级和淋巴结转移中的应用价值。
材料与方法：将 86 例经病理证实的食管癌患者按病理类型、组织学分级和淋巴结状态分为不同组。所有患者均行常规磁共振成像和扩散加权成像扫描，并测量肿瘤的表观扩散系数值。采用独立样本 t 检验和单因素方差分析比较不同病理类型、组织学分级和淋巴结状态下表观扩散系数值的差异。采用 Spearman 秩相关检验评价表观扩散系数值与组织学分级的相关性。绘制表观扩散系数值的受试者工作特征曲线，评价其对低分化和中高分化食管癌的鉴别诊断效率。
结果：食管鳞癌和腺癌之间以及有和无淋巴结转移患者之间的表观扩散系数值无显著差异（>.05）。不同组织学分级的食管癌之间的表观扩散系数值差异有统计学意义（<.05）。表观扩散系数值与组织学分级呈正相关（s = 0.802）。以表观扩散系数值≤1.25×10 mm/s 作为诊断低分化食管癌的截断值，其灵敏度为 84.3%，特异度为 94.3%。
结论：表观扩散系数值有助于预测食管癌的组织学分级，在选择最佳治疗方案之前可能有助于增加病变特征的描述。然而，它们与食管癌的病理类型和淋巴结转移无关。
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