磁共振扩散加权成像在预测乳腺癌肝转移早期疗效中的作用

摘要
图/表
参考文献(16)
相关文章 (15)

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的：探索磁共振扩散加权成像表观扩散系数（ADC）值在预测及早期评估乳腺癌肝转移（BCLM）化疗效果中的作用。方法：选择42例乳腺癌肝转移患者，分别于化疗前3 d、化疗后1周、2周及4周进行常规MRI及扩散加权成像（DWI），并测量病灶的ADC值。采用实体肿瘤疗效评价标准（RECIST）作为评价乳腺癌肝转移化疗疗效的评价标准。结果：42例乳腺癌肝转移患者86个病灶中，40个病灶对化疗有效，46个病灶对化疗无效。化疗前有效组ADC值（（1.06±0.07）×10-3 mm2/s）明显低于无效组（（1.22±0.14）×10-3 mm2/s），且差异具有统计学意义（P＜0.05）；化疗后1周，有效组ADC值（（1.08±0.13）×10-3 mm2/s，P=0.144）较化疗前有所增加，无效组ADC值（（1.20±0.16）×10-3 mm2/s，P=0.179）较化疗前有所降低，两者间差异均无明显统计学意义；化疗后2周及4周，有效组ADC值（（1.28±0.11）×10-3 mm2/s，（1.36±0.10）×10-3 mm2/s）较化疗前明显增高且差异有统计学意义（P＜0.05），而无效组无明显变化。ROC曲线下面积为0.846，以治疗前ADC=1.11×10-3 mm2/s作为判断化疗是否有效的界值，其敏感性与特异性为78.3%和87.5%。结论：治疗前ADC值结合治疗后2周ADC值有助于早期预测及评价BCLMs的化疗疗效。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	王亚婷
	朱艳
	郭莉莉
	史玉振
	陈伟
	柏根基

关键词 ：乳腺肿瘤, 肝肿瘤, 肿瘤转移, 磁共振成像

Abstract：Objective: To determine whether change of apparent diffusion coefficient(ADC) values could predict early response to chemotherapy in breast cancer liver metastases(BCLM). Methods: We retrospectively studied 42 patients with BCLMs(86 lesions) who had undergone conventional MRI and DWI at 3 days before chemotherapy and 1 week, 2 weeks, 4 weeks after chemotherapy. Selected patients were divided into responders(R) and non-responders(NR). The grouping reference was based on MRI according to response evaluation criteria in solid tumors(RECIST). Results: Eighty-six metastases were classified as 40 R and 46 NR. The difference in maximum tumor diameter of R group between pre-chemotherapy and 4 weeks after chemotherapy was significant(P<0.05). Pretreatment mean ADC((1.06±0.07)×10-3 mm2/s) of R group was significantly lower than that of NR group((1.22±0.14)×10-3 mm2/s)(P<0.05). After 1 week of chemotherapy, the mean ADC of R group increased slightly and the mean ADC of NR group decreased slightly, with no statistical significance. After 2 weeks and 4 weeks of chemotherapy, the mean ADC of R group increased significantly but not in NR group. The results of ROC curve showed that areas of under the curve were 0.846, pretreatment ADC of 1.11×10-3 mm2/s concluded BCLMs to chemotherapy ineffective sensitivity and specificity value were 78.3% and 87.5%, respectively. Conclusion: The pretreatment and 2 weeks after treatment ADC value may be helpful to predict early response to chemotherapy in BCLM.

Key words： Breast neoplasms Liver neoplasms Neoplasms metastasis Magnetic resonance imaging

收稿日期: 2016-08-09

PACS:	Ｒ737.9
	Ｒ735.7
	Ｒ445.2

通讯作者: 柏根基，南京医科大学附属淮安第一医院影像科，223300。E-mail：hybgj0451@163.com

作者简介: 王亚婷（1990-），女，江苏人，在读硕士研究生。E-mail：593793621@qq.com

引用本文:

王亚婷，朱艳，郭莉莉，史玉振，陈伟，柏根基. 磁共振扩散加权成像在预测乳腺癌肝转移早期疗效中的作用[J]. 中国临床医学影像杂志, 2017, 28(3): 180-183.
WANG Ya-ting, ZHU Yan, GUO Li-li, SHI Yu-zhen, CHEN Wei, BAI Gen-ji. Prediction of early response to chemotherapy in breast cancer liver metastases by DWI. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(3): 180-183.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2017/V28/I3/180

[1]van Walsum GA, de Ridder JA, Verhoef C, et al. Resection of liver metastases in patients with breast cancer: survival and prognostic factors[J]. Eur J Surg Oncol, 2012, 38(10): 910-917.
[2]Tampellini M, Berruti A, Gerbino A, et al. Relationship between CA 15-3 serum levels and disease extent in predicting overall survival of breast cancer patients with newly diagnosed metastatic disease[J]. Br J Cancer, 1997, 75(5): 698-702.
[3]赵京阳，顾梅，党受涛，等. 乳腺癌肝转移诊断及治疗的研究进展[J]. 中国医药，2015，10（11）：1720-1722.
[4]Sahani DV, Jiang T, Hayano K, et al. Magnetic resonance imaging biomarkers in hepatocellular carcinoma: association with response and circulating biomarkers after sunitinib therapy[J]. J Hematol Oncol, 2013, 6(1): 51-61.
[5]蒋朝霞，彭卫军，许玲辉，等. RECIST标准在乳腺癌转移治疗疗效评价中的应用与WHO标准比较[J]. 中国癌症杂志，2008，18（2）：106-109.
[6]饶智国，高建飞，章必成，等. 全身化疗联合肝动脉栓塞化疗治疗乳腺癌术后肝转移的临床疗效观察[J]. 现代肿瘤医学，2013，21（9）：1994-1996.
[7]Jacobs L, Intven M, van Lelyveld N, et al. Diffusion-weighted MRI for early prediction of treatment response on preoperative chemoradiotherapy for patients with locally advanced rectal cancer: a feasibility study[J]. Ann Surg, 2016, 263(3): 522-528.
[8]Liu Y, Sun H, Bai R, et al. Time-window of early detection of response to concurrent chemoradiation in cervical cancer by using diffusion-weighted MR imaging: a pilot study[J]. Radiat Oncol, 2015, 185(10): 185-193.
[9]何长久，任静，许国辉，等. 磁共振扩散加权成像预测与评价宫颈癌放化疗疗效的研究[J]. 中华放射医学与防护杂志，2014，34（11）：841-844.
[10]艾尔肯·阿不力孜，丁爽，巴哈提·哈立亚，等. 多b值DWI对肝脏转移瘤化疗早期疗效评估的初步研究[J]. 新疆医科大学学报，2015，38（9）：1166-1169.
[11]Liang HY, Huang YQ, Yang ZX, et al. Potential of MR histogram analyses for prediction of response to chemotherapy in patients with colorectal hepatic metastases[J]. Eur Radiol, 2016, 26(7): 2009-2018.
[12]van Rossum PS, van Lier AL, van Vulpen M, et al. Diffusion-weighted magnetic resonance imaging for the prediction of pathologic response to neoadjuvant chemoradiotherapy in esophageal cancer[J]. Radiother Oncol, 2015, 115(2): 163-170.
[13]梁晓，张红梅，叶枫，等. 扩散加权成像在预测直肠癌术前放化疗疗效中的价值[J]. 中华肿瘤杂志，2016，38（2）：133-137.
[14]Levy A, Caramella C, Chargari C, et al. Accuracy of diffusion-weighted echo-planar MR imaging and ADC mapping in the evaluation of residual cervical carcinoma after radiation therapy[J]. Gynecol Oncol, 2011, 123(1): 110-115.
[15]Zheng DX, Meng SC, Liu QJ, et al. Predicting liver metastasis of gastrointestinal tract cancer by diffusion-weighted imaging of apparent diffusion coefficient values[J]. World J Gastroenterol, 2016, 22(10): 3031-3037.
[16]Mungai F, Pasquinelli F, Mazzoni LN, et al. Diffusion-weighted magnetic resonance imaging in the prediction and assessment of chemotherapy outcome in liver metastases[J]. Radiol Med, 2014, 119(8): 625-633.