董越,董瑞彤,于岩岩,张瑞,胡启云,于韬,刘凡,罗娅红.月经状态对不同病理类型宫颈癌表观弥散系数值的影响[J].中国医学影像技术,2020,36(4):569~573
月经状态对不同病理类型宫颈癌表观弥散系数值的影响
Impact of menstrual status on the apparent diffusion coefficient of different pathological types of cervical cancer
投稿时间:2019-04-13  修订日期:2019-11-12
DOI:10.13929/j.issn.1003-3289.2020.04.022
中文关键词:  宫颈肿瘤  月经  磁共振成像
英文关键词:uterine cervical neoplasms  menstruation  magnetic resonance imaging
基金项目:沈阳市中青年科技创新人才支持计划项目(RC180269)、国家癌症中心攀登基金项目(NCC201806B011)。
作者单位E-mail
董越 中国医科大学肿瘤医院医学影像科, 辽宁 沈阳 110042  
董瑞彤 中国医科大学肿瘤医院医学影像科, 辽宁 沈阳 110042  
于岩岩 中国医科大学肿瘤医院医学影像科, 辽宁 沈阳 110042  
张瑞 中国医科大学肿瘤医院医学影像科, 辽宁 沈阳 110042  
胡启云 中国医科大学肿瘤医院医学影像科, 辽宁 沈阳 110042  
于韬 中国医科大学肿瘤医院医学影像科, 辽宁 沈阳 110042  
刘凡 中国医科大学肿瘤医院医学影像科, 辽宁 沈阳 110042  
罗娅红 中国医科大学肿瘤医院医学影像科, 辽宁 沈阳 110042 luoyahong8888@hotmail.com 
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中文摘要:
      目的 观察月经状态对不同病理类型宫颈癌表观弥散系数(ADC)值的影响。方法 回顾性分析352例经病理证实的宫颈癌患者的MRI及DWI资料,其中317例鳞癌和35例腺癌;177例未绝经,175例已绝经。于ADC图像宫颈癌病灶最大层面测量并记录病灶的ADC最大值(ADCmax)、最小值(ADCmin)和平均值(ADCmean)。比较宫颈鳞癌与腺癌ADC值差异、绝经与未绝经患者宫颈鳞癌和腺癌ADC值差异;分别比较宫颈鳞癌及腺癌中绝经与未绝经患者ADC值差异。结果 宫颈鳞癌ADCmean和ADCmin均低于腺癌(t=-2.05,-2.28,P均<0.05)。未绝经患者中,宫颈鳞癌ADCmean和ADCmin均低于腺癌(t=-4.40,-5.40,P均<0.05);而绝经患者中,宫颈鳞癌ADCmean、ADCmin和ADCmax均与腺癌差异无统计学意义(t=0.82,1.57,0.45,P均>0.05)。宫颈鳞癌及腺癌中,未绝经患者的ADCmean、ADCmax和ADCmin均高于绝经患者(t=-3.96,-2.53,-2.78及t=-3.71,-1.15,-5.01,P均<0.05)。结论 不同病理类型宫颈癌的ADC值不同,且受患者月经状态影响;未绝经患者中腺癌的ADC值高于鳞癌,绝经患者中腺癌ADC值与鳞癌相仿。未绝经患者宫颈癌病灶ADC值均高于绝经患者。
英文摘要:
      Objective To explore the impact of menstrual status on the apparent diffusion coefficient (ADC) of cervical squamous cell carcinoma and adenocarcinoma. Methods MRI and DWI data of 352 patients with pathologically confirmed cervical cancer were retrospectively analyzed, including 317 cases of cervical squamous cell carcinoma and 35 with cervical adenocarcinoma. Among 352 patients, 177 were premenopausal and 175 were menopausal. The maximum ADC (ADCmax), minimum ADC (ADCmin) and mean ADC (ADCmean) values of the lesions were measured and recorded at the maximum level of cervical carcinoma on ADC images. ADC values were compared between cervical squamous cell carcinoma and adenocarcinoma, also between postmenopausal and pre-menopausal patients, further between cervical squamous cell carcinoma and adenocarcinoma in postmenopausal and pre-menopausal patients. Results The ADCmin and ADCmean values of cervical squamous cell carcinoma were lower than those of adenocarcinoma (t=-2.05, -2.28, both P<0.05). For pre-menopausal patients, the ADCmean and ADCmin values of cervical squamous cell carcinoma were lower than those of adenocarcinoma (t=-4.40, -5.40, both P<0.05), while for menopausal patients, the ADCmean, ADCmin and ADCmax of cervical squamous cell carcinoma were similar to those of adenocarcinoma (t=0.82, 1.57, 0.45, all P>0.05). The ADCmin, ADCmean and ADCmax values of premenopausal patients with cervical squamous cell carcinoma or adenocarcinoma were higher than those of postmenopausal patients (t=-3.96, -2.53, -2.78 and t=-3.71, -1.15, -5.01, all P<0.05). Conclusion ADC values of cervical cancers are different with different pathologic types, which affected by the menstrual statue of patients. ADC value of adenocarcinoma is higher than that of squamous cell carcinoma in pre-menopausal patients, while is similar in post-menopausal patients. ADC values of cervical cancers in pre-menopausal patients are higher than those in post-menopausal patients.
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