1.5T磁共振扩散加权成像在直肠癌诊断中的应用及其与MVD VEGF及LVD的关系

doi:10.3969/j.issn.1006-6233.2022.08.010

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摘要 目的: 探究1.5T磁共振扩散加权成像(DWI)的在直肠癌中的应用及表观弥散系数(ADC值)与微血管密度(MVD)、血管内皮生长因子(VEGF)及淋巴管密度(LVD)的关系。方法: 回顾性选取2018年4月至2021年4月期间在本院收治的的直肠癌患者86例的临床病理资料。所有患者治疗前均进行DWI检查,并通过免疫组化法测得其MVD、VEGF及LVD表达水平。分析DWI在直肠癌诊断中的价值,并以Person相关性分析ADC值与MVD、VEGF及LVD之间的关系。结果: 高分化程度、T2期及N₀的直肠癌患者ADC值均高于低+中分化程度、T4期及N_1~2期者(P<0.05),但高分化程度、T2期及N₀的直肠癌患者MVD、VEGF及LVD表达均低于低+中分化程度、T4期及N_1~2期。Person相关性显示,ADC值与MVD、VEGF、LVD均呈负相关(r=-0.428、-0.505、-0.474,P<0.05)。ROC结果显示,ADC值预测直肠癌分化程度、T分期及N分期的AUC分别为0.904、0.839、0.897,敏感度、特异度:分化程度为83.3%、87.8%,T分期为68.4%、89.6%,N分期为91.9%、85.7%。结论: 1.5T磁共振DWI序列预测直肠癌T分期、N分期及分化程度的灵敏度及特异度均较高,且ADC值与MVD、VEGF及LVD表达关系密切,可为临床治疗及预后评估提供参考依据。

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关键词 ：直肠癌, 磁共振扩散加权成像, 表观弥散系数, 微血管密度, 血管内皮生长因子, 淋巴管密度

Abstract：Objective: To explore the application of 1.5T magnetic resonance diffusion weighted imaging (DWI) in rectal cancer and the relationship between apparent diffusion coefficient (ADC value) and microvessel density (MVD), vascular endothelial growth factor (VEGF) and lymphatic vessel density (LVD). Methods: The clinicopathological data of 86 patients with rectal cancer admitted to our hospital from April 2018 to April 2021 were retrospectively selected. All patients were examined by DWI before treatment, and their MVD, VEGF and LVD expression levels were measured by immunohistochemistry. The value of DWI in the diagnosis of rectal cancer, and the relationship between ADC value and MVD, VEGF and LVD with Person correlation were analyzed. Results: ADC values were higher in patients with highly differentiated, T2 and N₀ rectal cancers than those with low+moderately differentiated, T4 and N_1~2 stages (P<0.05), but MVD, VEGF and LVD expression were lower in patients with highly differentiated, T2 and N₀ rectal cancers than those with low+moderately differentiated, T4 and N_1~2 stages. Person correlation showed that ADC values were negatively correlated with MVD, VEGF and LVD (r=-0.428, -0.505, -0.474, P<0.05). ROC results showed that ADC values predicted the degree of differentiation, T-stage and N-stage of rectal cancer with AUCs of 0.904, 0.839 and 0.897, respectively.Sensitivity and specificity: 83.3% and 87.8% for differentiation, 68.4% and 89.6% for T-stage and 91.9% and 85.7% for N-stage. Conclusion: The sensitivity and specificity of 1.5T MRI DWI sequences in predicting T-stage, N-stage and differentiation degree of rectal cancer are high, and the ADC values are closely related to MVD, VEGF and LVD expression, which can provide a reference basis for clinical treatment and prognosis assessment.

Key words： Rectal cancer Magnetic resonance diffusion weighted imaging Apparent diffusion coefficient Microvessel density Vascular endothelial growth factor Lymphatic vessel density

基金资助:2018年度海南省卫生计生行业科研项目,(编号:1801320114A2003)

引用本文:

曾方毅, 羊章哲, 王昆, 沈长青, 刘丽杰. 1.5T磁共振扩散加权成像在直肠癌诊断中的应用及其与MVD VEGF及LVD的关系[J]. 河北医学, 2022, 28(8): 1285-1290.
ZENG Fangyi, YANG Zhangzhe, WANG Kun, et al. The Application of 1.5T Magnetic Resonance Diffusion Weighted Imaging in the Diagnosis of Rectal Cancer and Its Relationship with MVD, VEGF and LVD. HeBei Med, 2022, 28(8): 1285-1290.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.08.010 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I8/1285