目的:评估整个肿瘤体积(WTV)和功能性肿瘤体积(FTV)的表观扩散系数(ADC)在确定上皮性卵巢癌(EOCs)病理预后因素中的应用。
方法:本研究评估了在2017年1月至2022年8月期间诊断为EOC并接受常规磁共振成像和扩散加权成像的155例连续患者。最大,minimum,和整个肿瘤的平均ADC值(ADCwmax,ADCwmin,和ADCwmean,分别)和功能性肿瘤(ADCfmax,ADCfmin,和ADCfmean,分别)以及WTV和FTV都是从ADC映射中得出的。采用单因素和多因素logistic回归分析及受试者工作特征曲线(ROC)分析评估ADC值与病理预后因素的相关性。即亚型,淋巴结转移(LNM),Ki-67指数,和p53表达。
结果:II型EOC的ADCfmean值显着降低,LNM阳性,与I型EOC相比,高Ki-67指数组,LNM-阴性,和低Ki-67指数组(p≤0.001)。同样,与野生型p53组相比,突变型p53组的ADCwmean和ADCfmean值较低(p≤0.001).此外,ADCfmean显示评估II型EOC的ROC曲线下面积(AUC)最高(0.725),LNM阳性(0.782),在给定的ROC曲线中,高Ki-67指数(0.688)样本,而ADCwmean和ADCfmean均显示用于评估p53表达的高AUC(分别为0.694和0.678)。
结论:FTV导出的ADC值,尤其是ADCfmean,可用于评估EOCs的术前预后因素。
OBJECTIVE: To assess the utility of apparent diffusion coefficients (ADCs) of whole tumor volume (WTV) and functional tumor volume (FTV) in determining the pathologicalprognostic factors in epithelial ovarian cancers (EOCs).
METHODS: A total of 155 consecutive patients who were diagnosed with EOC between January 2017 and August 2022 and underwent both conventional magnetic resonance imaging and diffusion-weighted imaging were assessed in this study. The maximum, minimum, and mean ADC values of the whole tumor (ADCwmax, ADCwmin, and ADCwmean, respectively) and functional tumor (ADCfmax, ADCfmin, and ADCfmean, respectively) as well as the WTV and FTV were derived from the ADC maps. The univariate and multivariate logistic regression analyses and receiver operating characteristic curve (ROC) analysis were used to assess the correlation between these ADC values and the pathological prognostic factors, namely subtypes, lymph node metastasis (LNM), Ki-67 index, and p53 expression.
RESULTS: The ADCfmean value was significantly lower in type II EOC, LNM-positive, and high-Ki-67 index groups compared to the type I EOC, LNM-negative, and low-Ki-67 index groups (p ≤ 0.001). Similarly, the ADCwmean and ADCfmean values were lower in the mutant-p53 group compared to the wild-type-p53 group (p ≤ 0.001). Additionally, the ADCfmean showed the highest area under the ROC curve (AUC) for evaluating type II EOC (0.725), LNM-positive (0.782), and high-Ki-67 index (0.688) samples among the given ROC curves, while both ADCwmean and ADCfmean showed high AUCs for assessing p53 expression (0.694 and 0.678, respectively).
CONCLUSIONS: The FTV-derived ADC values, especially ADCfmean, can be used to assess preoperative prognostic factors in EOCs.