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目的探讨表观扩散系数(ADC)在不同组织分化类型与临床分期直肠癌中的应用价值。方法回顾性分析临床确诊的73例直肠癌患者的扩散加权成像(DWI)资料,测量其ADC值。根据术后病理组织分化类型分为6组:高分化(n=11)、高中分化(n=8)、中分化(n=29)、中低分化(n=7)、低分化(n=5)、黏液腺癌(n=13);根据TNM将临床分期分为4期:Ⅰ(n=13)、Ⅱ(n=16)、Ⅲ(n=34)、Ⅳ(n=10),对不同组织分化及临床分期直肠癌ADC值进行统计学分析,P≤0.05为差异有统计学意义。结果不同组织分化类型直肠癌ADC值差异有统计学意义(F=30.993,P=0.000),组间ADC值两两比较:黏液腺癌与其余各组、高与中低、高与低、高中与中低、高中与低、中与低分化组间差异有统计学意义(P<0.05);高与高中、高与中、高中与中、中与中低、中低与低分化组间差异无统计学意义(P>0.05)。黏液腺癌ADC值最高(1480.05±236.05)×10~(-3)mm~2/s,其余各组随着肿瘤分化程度的减低,ADC值有逐渐减低的趋势。不同临床分期直肠癌ADC值差异无统计学意义(F=5.695,P=0.127)。结论直肠癌ADC值可以作为判断肿瘤不同组织分化类型的生物影像指标,但对不同临床分期的判断无帮助。
Objective To investigate the value of apparent diffusion coefficient (ADC) in different types of tissue and clinical staging of rectal cancer. Methods The data of diffusion weighted imaging (DWI) in 73 clinically diagnosed patients with rectal cancer were analyzed retrospectively to measure the ADC value. According to the postoperative pathological type, the patients were divided into 6 groups: well differentiated (n = 11), high differentiated (n = 8), moderately differentiated (n = 29), moderately differentiated (n = (N = 13), Ⅱ (n = 16), Ⅲ (n = 34), Ⅳ (n = 10), and mucinous adenocarcinoma Statistical analysis was performed on the ADC value of different tissues and clinical staging of rectal cancer. P≤0.05 was considered statistically significant. Results There was significant difference in the ADC value of rectal cancer with different histological types (F = 30.993, P = 0.000). There was no significant difference in the ADC value between groups: mucinous adenocarcinoma and other groups, high and low, high and low, And middle and low, high school and low, moderate and poorly differentiated group was statistically significant (P <0.05); high and high school, high and middle and high school and in the middle and low, low and poorly differentiated group differences No statistical significance (P> 0.05). The ADC value of mucinous adenocarcinoma was the highest (1480.05 ± 236.05) × 10 ~ (-3) mm ~ 2 / s. The ADC value of mucinous adenocarcinoma was gradually decreased with the decrease of tumor differentiation. ADC values of different clinical staging rectal cancer showed no significant difference (F = 5.695, P = 0.127). Conclusion The ADC value of rectal cancer can be used as a bio-imaging index to determine the different types of tumors, but it is not helpful to judge the different clinical stages.