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目的研究ADC差值在评估宫颈癌病理分级方面的应用价值和分析最大ADC差值与微血管密度(MVD)、血管内皮生长因子(VEGF)表达之间的相关性。方法这项前瞻性研究包括56例宫颈癌病人。所有的病人都接受常规MRI和DWI检查。MVD和VEGF分别用抗cd34和抗VEGF免疫组化染色评定。结果最大ADC差值和MVD计数在不同病理分级具有统计学意义(P<0.001,P<0.001)。最大ADC差值和病理肿瘤分级之间呈显著正线性相关关系(P<0.001),MVD计数和病理肿瘤分级的关系也是如此(P<0.001)。VEGF表达水平和病理肿瘤分级之间差异无统计学意义(P=0.222)。最大ADC差值与MVD计数和VEGF表达水平均呈正相关(P<0.001,P<0.001)。结论宫颈癌最大ADC差值的定量分析可能代表肿瘤的分化程度,在肿瘤微循环和灌注方面提供有价值的信息,从而使一种有前途的新的无创性方法来评估病理分级成为可能,这种方法可能成为评估肿瘤血管生成的替代方法。要点①扩散加权MR成像提供了关于宫颈癌的许多新参数。②研究了最大ADC差值和病理肿瘤分级之间的关系。③定量分析可能提供了肿瘤微循环和灌注方面的有价值的信息。④宫颈癌最大ADC差值可能成为评估肿瘤血管生成的替代方法。
Objective To investigate the value of ADC differential in assessing the pathological grade of cervical cancer and to analyze the correlation between maximal ADC difference and microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression. Methods This prospective study included 56 patients with cervical cancer. All patients underwent routine MRI and DWI. MVD and VEGF were respectively evaluated by anti-cd34 and anti-VEGF immunohistochemical staining. Results The maximum difference of ADC and MVD in different pathological grades were statistically significant (P <0.001, P <0.001). There was a significant positive linear correlation between maximum ADC difference and histological grade (P <0.001), as was the relationship between MVD count and pathological grade (P <0.001). There was no significant difference between VEGF expression and pathological grade (P = 0.222). The maximum ADC difference was positively correlated with MVD count and VEGF expression (P <0.001, P <0.001). Conclusion The quantitative analysis of the maximum ADC difference in cervical cancer may represent the degree of tumor differentiation and provide valuable information on tumor microcirculation and perfusion, thus making it a promising new noninvasive method for assessing pathological grading, which This approach may serve as an alternative method of assessing tumor angiogenesis. Key Points ① Diffusion-weighted MR imaging provides many new parameters for cervical cancer. ② studied the maximum difference between ADC and pathological tumor grade relationship. Quantitative analysis may provide valuable information on tumor microcirculation and perfusion. ④ The maximum difference in cervical cancer ADC may be an alternative method of assessing tumor angiogenesis.