摘要
目的探讨磁共振弹性成像(magnetic resonance elastography, MRE)弹性值评价胰腺导管腺癌(pancreatic adenocarcinoma,PDAC)肿瘤分级的价值,分析其对评估PDAC患者预后的价值。材料与方法 对62例诊断PDAC且接受胰十二指肠切除术患者行MRE检查,测量肿瘤弹性值,并从术后病理报告中提取肿瘤位置、切缘状态和分级等信息,观察肿瘤硬度与组织病理学的关系,分析PDAC患者总生存时间(overall survival,OS)的独立影响因素。结果 所有PDAC的平均弹性值为(3.06±0.82) kPa。高分化、中分化及低分化胰腺癌的弹性值分别为(2.31±0.62) kPa、(2.98±0.78) kPa及(3.83±1.08) kPa,不同分级间弹性值差异有统计学意义(P<0.001)。PDAC弹性值与病理分级呈正相关(rs=0.831,P<0.001)。MRE弹性值诊断高、中-低分化与高-中、低分化PDAC的曲线下面积(area under curve,AUC)分别为0.826及0.884。弹性值是PDAC患者OS的独立影响因子(P<0.001)。结论 PDAC患者弹性值与肿瘤组织学分级密切相关,弹性值越高,病理级别越高,患者存活时间越短。
Objective: To investigate the prognostic value of magnetic resonance elastography(MRE) in patients with pancreatic ductal adenocarcinoma(PDAC) and its correlation with histopathological grade. Materials and Methods: MRE examination was performed in62 patients diagnosed with PDAC and undergoing pancreaticoduodenectomy. The stiffness was measured, tumor location, margin status and histopathological grade were extracted from postoperative pathological reports. The Cox proportional risk model was used to determine the role of stiffness in predicting overall survival(OS) and the relationship between tumor hardness and pathology was analyzed. Results: The mean stiffness of all PDACs was(3.06±0.82) kPa. The mean stiffness of patients with well, moderate, and poorly differentiated PDAC were(2.31±0.62) kPa,(2.98±0.78) kPa and(3.83±1.08) kPa, respectively. There were statistically significant differences in elasticity among different histopathological grades(P<0.001). The elasticity of PDAC were positively correlated with the pathological grades of PDAC(rs=0.831, P<0.001). The area under curve(AUC) of MRE stiffness diagnosed well and moderate-poorly differentiated, well-moderate and poorly differentiated PDAC were 0.826 and 0.884, respectively. Stiffness was an independent risk factor for the survival time of PDAC patients(P<0.001). Conclusions: The stiffness of PDAC was significant correlation to pathological grades of tumor;and the high stiffness was associated with lower overall survival rates after attempted curative resection of PDAC.
作者
宋奇科
钟时玲
刘媛媛
杨锐
石喻
SONG Qike;ZHONG Shiling;LIU Yuanyuan;YANG Rui;SHI Yu(Department of Radiology,Shengjing Hospital of China Medical University,Shenyang 110004,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2022年第3期26-30,共5页
Chinese Journal of Magnetic Resonance Imaging
基金
国家自然科学基金项目(82071885、81771802、81771893)
中组部国家万人计划青年拔尖人才项目。
关键词
胰腺肿瘤
预后
弹性成像技术
磁共振成像
硬度值
诊断
生存期
pancreatic neoplasms
prognosis
elasticity imaging techniques
magnetic resonance imaging
stiffness
diagnosis
overall survival
