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目的研究中央腺前列腺癌灶和膀胱内尿液表观扩散系数比值(rADC)与Gleason评分的关系,评价ADC值在中央腺前列腺癌Gleason分级中的诊断价值。资料与方法使用1.5 T MR扫描仪对69例经根治术或穿刺活检病理证实的前列腺癌患者进行扩散加权成像(DWI)检查,b值取0和800 s/mm2,分别测量中央腺癌灶和膀胱内尿液相对ADC值,计算中央腺前列腺癌的rADC;根据病理结果将中央腺前列腺癌分为Gleason 3+3,3+4,4+3,≥4+4四组,将各组中央腺前列腺癌rADC与Gleason评分进行单因素方差分析(one-way ANOVA),并进行组间两两比较。采用Pearson相关分析检验中央腺前列腺癌rADC与Gleason评分的相关性。将中央腺前列腺癌Gleason评分≤7与Gleason评分≥8两组之间分别进行受试者工作特性(ROC)曲线分析,判断低中危组与高危组诊断界值点。结果中央腺前列腺癌Gleason评分3+3组与其余各组间rADC差异均有统计学意义(P<0.05),3+4,4+3、≥4+4各组间rADC差异无统计学意义(P>0.05)。中央腺前列腺癌rADC与Gleason评分呈负相关(相关系数r=-0.58,P<0.01;),Gleason评分越高,rADC越小。以rADC值0.225作为阈值,鉴别低中危组与高危组中央腺前列腺癌的敏感度和特异度分别为71.4%和85%。结论中央腺前列腺癌ADC值与Gleason评分有一定相关性,有助于中央腺前列腺癌临床危险度的分级判定。
Objective To study the relationship between apparent diffusion coefficient ratio (rADC) of central glandular prostate foci and urinary bladder and Gleason score and to evaluate the diagnostic value of ADC in Gleason grading of central glandular prostate cancer. Materials and Methods Diffusion-weighted imaging (DWI) was performed on 69 prostate cancer patients confirmed by radical or biopsy with a 1.5 T MR scanner. The b values were taken as 0 and 800 s / mm2, respectively. Central adenocarcinoma and According to the pathological results, the central gland prostate cancer was divided into four groups of Gleason 3 + 3, 3 + 4, 4 + 3, and 4 + 4, and the central part of each group Adeno-prostate cancer rADC and Gleason scores were analyzed by one-way ANOVA and compared between groups. Pearson correlation analysis was used to examine the correlation between rADC and Gleason score in central adenocarcinoma of the prostate. The receiver operating characteristic (ROC) curves of Gleason score ≤7 and Gleason score ≥8 of central gland prostate cancer were respectively analyzed to determine the diagnostic cutoff point between low-risk group and high-risk group. Results There was significant difference in rADC between Gleason score 3 + 3 group and other groups (P <0.05), there was no significant difference in rADC between 3 + 4, 4 + 3 and 4 + 4 groups (P> 0.05). There was a negative correlation between rADC and Gleason score in central glandular prostate cancer (r = -0.58, P <0.01). The higher the Gleason score, the lower rADC was. The rADC value of 0.225 as the threshold, the identification of low-risk group and high-risk group of central gland prostate cancer sensitivity and specificity were 71.4% and 85%. Conclusion The ADC value of central glandular prostate cancer has a certain correlation with Gleason score, which is helpful to grade the clinical risk of central glandular prostate cancer.