【摘要】：目的探討利用MR擴散加權成像的表觀擴散系數(shù)(ADC值)預測鼻咽癌放療敏感度的可行性。方法 97例鼻咽癌患者在放療前行MR擴散加權成像檢查,并測量腫瘤灶ADC值。根據(jù)放射治療后的效果將鼻咽癌患者按放療敏感度進行分組,放療敏感組74例、放療抗拒組23例。分析放療敏感度與ADC值、病理分型、T分期的相互關系。結(jié)果放療敏感組的ADC值為(0.792±0.121)×10-3mm2/s,其中非角化型分化型癌23例,非角化型未分化癌51例,T1期10例,T2期33例,T3期22例,T4期9例。放療抗拒組的ADC值為(0.730±0.104)×10-3 mm2/s,其中非角化型分化型癌8例,非角化型未分化癌15例,T1期3例,T2期4例,T3期7例,T4期9例。兩組間在ADC值、T分期方面差異均有統(tǒng)計學意義(t=2.199,P=0.030;χ2=10.287,P=0.016),在病理分型方面差異無統(tǒng)計學意義(χ2=0.111,P=0.740)。各T分期的ADC值整體上差異有統(tǒng)計學意義(F=8.597,P=0.000),隨著T分期的增高,ADC值呈現(xiàn)下降趨勢。ADC值、T分期預測鼻咽癌放療敏感度的ROC曲線下的面積(Az)值分別為0.657、0.661。當ADC值取0.737×10-3 mm2/s為診斷閾值時,其診斷價值最大,敏感度為68.9%,特異性為69.6%。結(jié)論 ADC值可以預測鼻咽癌放療敏感度,其價值接近于T分期,最佳診斷閾值為0.737×10-3 mm2/s。
[Abstract]:Objective to study the feasibility of predicting radiotherapy sensitivity of nasopharyngeal carcinoma (NPC) by using apparent diffusion coefficient (ADC) of MR diffusion weighted imaging. Methods MR diffusion weighted imaging was performed in 97 patients with nasopharyngeal carcinoma before radiotherapy, and ADC value of tumor focus was measured. According to the effect of radiotherapy, patients with nasopharyngeal carcinoma were divided into four groups according to the sensitivity of radiotherapy, 74 cases in the radiosensitive group and 23 cases in the resistant group. The relationship between the sensitivity of radiotherapy and ADC, pathological classification and T stage was analyzed. Results the ADC values of radiotherapy sensitive group were (0.792 鹵0.121) 脳 10 ~ (-3) mm ~ (-2) / s, including 23 cases of non-keratinizing differentiated carcinoma, 51 cases of non-keratinized undifferentiated carcinoma, 10 cases of T1 stage, 33 cases of T2 stage, 22 cases of T3 stage and 9 cases of T4 stage. The ADC values of radiotherapy resistant group were (0.730 鹵0.104) 脳 10 ~ (-3) mm2/s, including 8 cases of non-keratinizing differentiated carcinoma, 15 cases of non-keratinized undifferentiated carcinoma, 3 cases of T1 stage, 4 cases of T2 stage, 7 cases of T3 stage and 9 cases of T4 stage. There were significant differences in ADC and T staging between the two groups (t = 2.199P = 0.030; 蠂 ~ 2 = 10.287 / P = 0.016), but there was no significant difference in pathological classification between the two groups (蠂 ~ 2 / 0.111 / P ~ (0.740). The ADC value of each T stage was significantly different (F = 8.597, P < 0. 000). With the increase of T stage, the ADC value showed a downward trend. The area (Az) values under the ROC curve for predicting radiotherapy sensitivity of nasopharyngeal carcinoma by T staging were 0.657 鹵0.661respectively. When the ADC value was 0.737 脳 10 ~ (-3) mm2/s, the diagnostic value was the highest, the sensitivity was 68.9 and the specificity was 69.6. Conclusion ADC value can predict the radiosensitivity of nasopharyngeal carcinoma, and its value is close to T stage. The best diagnostic threshold is 0.737 脳 10 ~ (-3) mm2/s..
【作者單位】： 廣州醫(yī)科大學附屬腫瘤醫(yī)院核醫(yī)學科;廣州醫(yī)科大學附屬腫瘤醫(yī)院放射科;
【基金】：廣州市醫(yī)藥衛(wèi)生科技項目(20141A011093)
【分類號】：R739.63

【參考文獻】

相關期刊論文 前4條

1 于小平;李飛平;盧強;胡英;王暉;;鼻咽癌磁共振灌注定量參數(shù)及ADC值與T分期的關系[J];放射學實踐;2014年11期

2 趙維勇;孫新臣;;放射治療增敏的研究現(xiàn)狀[J];臨床腫瘤學雜志;2012年07期

3 潘建基;宗井鳳;;調(diào)強放射治療模式下鼻咽癌多學科治療策略的思考[J];中國腫瘤臨床;2012年24期

4 朱培楊;周瑋;黃小燕;;MR擴散加權成像在鼻咽良惡性病變及鼻咽癌T分期中的診斷價值[J];中國現(xiàn)代醫(yī)生;2014年36期

【共引文獻】

相關期刊論文 前10條

1 傅升;樊麗娜;周文土;;術前化療、放療及手術治療中晚期口腔鱗癌的臨床研究[J];臨床口腔醫(yī)學雜志;2014年10期

2 王鎮(zhèn)南;唐志;喻嫦娥;李淑慧;楊東紅;;奈達鉑提高鼻咽癌CNE-2細胞放射敏感性的體外實驗研究[J];吉林醫(yī)學;2015年07期

3 劉偉;徐鑫;劉媛媛;劉斌;王喜梅;;喜泊分聯(lián)合放療對小鼠H22肝癌移植瘤的抑瘤增敏作用研究[J];中國生化藥物雜志;2014年03期

4 姚p，

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