目的:本研究的目的是评估表观扩散系数(ADC)值预测非小细胞肺癌(NSCLC)病理亚型和分级的有效性。
方法:从2018年1月至2020年3月,48例经手术诊断的NSCLC病例纳入本研究。要获得ADC值,构建了ADC图,肿瘤上有一个感兴趣的区域。从病变的不同位置测量了三次值,并记录这些测量的平均值。所有MRI扫描均由两名放射科医师一致评价。
结果:共有14例鳞状细胞癌,32例腺癌,2例为大细胞癌。腺癌的平均ADC值,鳞状细胞癌,大细胞癌为1.51±0.19×10-3mm2/s,1.32±0.15×10-3mm2/s,和1.39±0.25×10-3mm2/s,分别。其中1级11例,2级27例,3级10例。1级肿瘤的平均ADC值为1.44±0.14×10-3mm2/s,2级肿瘤1.25±0.10×10-3mm2/s,3级肿瘤为1.07±0.15×10-3mm2/s。区分2级和1级肿瘤的临界值为1.31±0.11×10-3mm2/s(灵敏度为85%,75%特异性)。区分3级和2级肿瘤的临界值为1.11±0.15×10-3mm2/s(灵敏度为87%,69%的特异性)。
结论:ADC值可以准确预测NSCLC组织病理学亚型和肿瘤分级。
OBJECTIVE: The aim of this study is to evaluate the effectiveness of apparent diffusion coefficient (ADC) values in predicting pathologic subtypes and grade in non-small-cell lung cancer (NSCLC).
METHODS: From January 2018 to March 2020, 48 surgically diagnosed NSCLC cases were included in this study. To obtain ADC values, ADC maps were constructed, and a region of interest was put on the tumor. The values were measured three times from different places of the lesion, and the mean value of these measurements was recorded. All MRI scans were evaluated by two radiologists in consensus.
RESULTS: A total of 14 cases were squamous cell cancer, 32 cases were adenocarcinoma, and 2 cases were large cell carcinoma. The mean ADC values of adenocarcinoma, squamous cell carcinoma, and large cell cancer were 1.51 ± 0.19 × 10-3 mm2/s, 1.32 ± 0.15 × 10-3 mm2/s, and 1.39 ± 0.25 × 10-3 mm2/s, respectively. There were 11 grade 1, 27 grade 2, and 10 grade 3 NSCLC cases. The mean ADC value was 1.44 ± 0.14 × 10-3 mm2/s in grade 1 tumors, 1.25 ± 0.10 × 10-3 mm2/s in grade 2 tumors, and 1.07 ± 0.15 × 10-3 mm2/s in grade 3 tumors. The cut-off value to discriminate grade 2 from grade 1 tumors was 1.31 ± 0.11 × 10-3 mm2/s (85% sensitivity, 75% specificity). The cut-off value to discriminate grade 3 from grade 2 tumors was 1.11 ± 0.15 × 10-3 mm2/s (87% sensitivity, 69% specificity).
CONCLUSIONS: ADC values can accurately predict NSCLC histopathologic subtypes and tumor grade.