DCE-MRI定量参数和ADC值对前列腺癌的临床诊断价值及ADC值与血清PSA、P504S的相关性-现代医学

DCE-MRI定量参数和ADC值对前列腺癌的临床诊断价值及ADC值与血清PSA、P504S的相关性

单位：如皋市人民医院放射科, 江苏如皋 226500

分类号：R445.2;R737.25

出版年·卷·期（页码）：2017·36·第九期（1266-1270）

摘要：

目的：探讨磁共振动态增强扫描（DCE-MRI）定量参数和表观扩散系数（ADC）对前列腺癌的临床诊断价值及ADC与血清前列腺特异抗原（PSA）、α-甲基酰基辅酶A消旋酶（P504S）的相关性。方法：选取本院2012年4月至2015年7月确诊为前列腺病变的60例患者为研究对象，其中前列腺癌32例（前列腺癌组），前列腺增生28例（前列腺增生组）。所有患者均进行常规磁共振检查、DCE-MRI及扩散加权成像（DWI）检查。同时选取30例健康者（正常组）进行常规磁共振检查作为对照。比较3组患者的DCE-MRI定量参数、DWI信号强度值和ADC值，血清PSA、P504S表达情况以及ADC与PSA、P504S的相关性。结果：3组患者的DCE-MRI定量参数相比，前列腺癌组最高，正常组最低，3组差异显著（P<0.05）。前列腺癌患者随着扩散敏感系数（b值）的升高，DWI信号强度增加，ADC值则表现为低信号；前列腺增生组随着b值的升高，DWI信号强度变化不显著，而正常组则随着b值的升高，DWI信号强度降低，且前列腺增生组和正常组的ADC值均表现为高信号，3组差异显著（P<0.05）。前列腺癌组和前列腺增生组的患者PSA表达水平无显著差异（P>0.05），而P504S表达前列腺癌组显著高于前列腺增生组（P<0.05）。相关性分析显示ADC值与PSA、P504S均呈显著负相关（P<0.05）。结论：DCE-MRI可用于前列腺癌的诊断及鉴别；ADC值与前列腺的特异性抗原PSA、P504S呈显著负相关，其测量有助于对前列腺癌的生物学特性进行初步评估。

Objective: To investigate the clinical diagnosis value of DCE-MRI quantitative parameters and ADC values in patients with prostate cancer and the correlations with serum PSA and P504S. Methods: 60 patients with prostate cancer in our hospital from Apr, 2012 to Jul, 2015 were selected as the research objects, including 32 cases of prostate cancer (prostate cancer group), 28 patients with benign prostatic hyperplasia (BPH group). All patients were examined by routine MRI, DCE-MRI and DWI. At the same time, 30 healthy people were selected as the control group. DCE-MRI quantitative parameters, DWI signal intensity, ADC values, the expressions of serum PSA, P504S, and the correlations between ADC and PSA, P504S were compared. Results: DCE-MRI quantitative parameters in the 3 groups were compared, there was significant differences among 3 groups (P<0.05). With the increase of diffusion sensitive coefficient (b value), DWI signal intensity increased and ADC value showed low signal in patients with prostate cancer. In BPH group, with the increase of b value, the signal intensity of DWI did not change significantly, while in normal group, the signal intensity of DWI decreased with the increase of b value, and the ADC values of BPH group and normal group showed high signal, there were significant differences in the 3 groups (P<0.05). There was no significant difference on the expression of PSA between the prostate cancer group and the BPH group (P>0.05), while the expression of P504S in prostate cancer group was significantly higher than that in the BPH group(P<0.05). Correlation analysis showed that ADC value was negatively correlated with PSA and P504S (P<0.05). Conclusion: DCE-MRI can be used in the diagnosis and differentiation of prostate cancer. The ADC value was negatively correlated with prostate specific antigen PSA and P504S, it is helpful to assess the biological characteristics of prostate cancer.

参考文献：

[1] TU L,HUDA N,GRIMES B R,et al.Widespread telomere instability in prostatic lesions[J].Mol Carcinogen,2015,55(5):842-852.
[2] 史振铎,韩从辉.前列腺炎与前列腺癌[J].东南大学学报:医学版,2012,31(6):768-770.
[3] LIU H,LIU Y,ZHAO Z,et al.A new background distribution-based active contour model for three-dimensional lesion segmentation in breast DCE-MRI[J].Med Phys,2014,41(8):082303.
[4] LI X,ARLINGHAUS L R,AYERS G D,et al.DCE-MRI analysis methods for predicting the response of breast cancer to neoadjuvant chemotherapy:pilot study findings[J].Magnet Reson Med,2014,71(4):1592-1602.
[5] 李慧燕,郑泽宇,许乙凯.运用多b值DWI探讨前列腺中央腺体癌的诊断[J].临床放射学杂志,2016,35(6):891-896.
[6] 刘莉,吴宁,欧阳汉,等.DWI在前列腺癌放疗疗效评估中的价值[J].放射学实践,2014,29(1):77-80.
[7] 魏国华,高志安.特异AT序列结合蛋白1和P504s在前列腺癌中的表达及临床意义[J].中国现代医学杂志,2015,25(23):32-34.
[8] RUKHSANA A,RUBY R,ZUBAIR A D,et al.Histopathological study of prostatic lesions on needle biopsies with serum prostate-specific antigen (PSA)[J].Int J Med Sci,2014,6(3):87-91.
[9] 刘聪雅,杨永生,陈武,等.前列腺癌与前列腺增生血管生成的比较[J].中国超声医学杂志,2015,31(7):634-636.
[10] 徐嬿,冷晓明,郑芸,等.3.0T DCE-MRI定量分析在前列腺癌与增生鉴别诊断中的应用价值[J].磁共振成像,2015,6(8):608-612.
[11] 贾媛,王海宝,余永强,等.DCE-MRI对前列腺平台型强化灶的鉴别诊断价值[J]. 临床放射学杂志,2016,35(4):589-592.
[12] 李加慧,李秋菊,于兵,等.DWI-MRI多b值水通道蛋白分子成像机理和方法学研究[J].中国临床医学影像杂志,2014,25(3):186-189.
[13] 崔凌,庄伟雄,文海忠.DCE-MRI灌注指标与MR DWI ADC值在前列腺癌患者中的关系分析[J].实用癌症杂志,2014,29(5):522-524.
[14] 张方璟,朱记超,陈燕萍,等.不同b值时正常前列腺ADC值变化与年龄相关性研究[J].中国临床医学影像杂志,2015,26(1):34-37.
[15] PARK S Y,KIM C K,PARK B K,et al.Comparison of apparent diffusion coefficient calculation between two-point and multipoint B value analyses in prostate cancer and benign prostate tissue at 3 T:preliminary experience[J].Am J Roentgenol,2014,203(3):287-294.
[16] PARK S Y,KIM C K,PARK B K,et al.Diffusion-tensor MRI at 3 T:differentiation of central gland prostate cancer from benign prostatic hyperplasia[J].Am J Roentgenol,2014,202(3):254-262.
[17] 唐庆来,姚茂银,薛君,等.PSMA、PSA在前列腺腺癌组织中的表达及其与腺癌临床分期的相关性分析[J].东南大学学报:医学版,2010,29(1):65-69.
[18] EGEVAD L,DELAHUNT B,SAMARATUNGA H,et al.Utility of reporting the percentage of high-grade prostate cancer[J].Eur Urol,2015,69(4):599-600.
[19] 谭敬安,陈焱君,陈瑞燕,等.良性前列腺增生及前列腺癌的ADC值与PAP、P504S、PSA表达的相关性研究[J].癌症进展,2015,13(5):529-532.
[20] 王超,聂勇,黄品信.前列腺癌肿瘤标志物的研究进展[J].现代泌尿生殖肿瘤杂志,2016,8(2):116-118.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录