TƯƠNG QUAN GIỮA HỆ SỐ KHUẾCH TÁN BIỂU KIẾN TRÊN CỘNG HƯỞNG TỪ KHUẾCH TÁN, KHÁNG NGUYÊN ĐẶC HIỆU TUYẾN TIỀN LIỆT VỚI ĐIỂM MÔ HỌC GLEASON TRONG UNG THƯ TUYẾN TIỀN LIỆT=Correlation between apparent diffusion coefficient on diffusion-weighted imaging, prostate-specific antigen levels with Gleason histological grading in prostate cancer

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Tác giả: Ngọc Hoa Phạm, Thái Hưng Phạm, Thị Phương Thảo Trương, Ngọc Huy Thông Võ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Điện quang và Y học hạt nhân Việt Nam, 2024

Mô tả vật lý: tr.49-55

Bộ sưu tập: Metadata

ID: 486875

Thêm vào giỏ

Mục tiêu: Tìm hiểu tương quan giữa hệ số khuếch tán biểu kiến (ADC), kháng nguyên đặc hiệu tuyến tiền liệt (PSA) với điểm Gleason (ĐG) và giá trị của chúng trong phân biệt ung thư tuyến tiền liệt (UTTTL) không và có ý nghĩa lâm sàng.Đối tượng và phương pháp nghiên cứu: Nghiên cứu cắt ngang tại Bệnh viện Đại học Y Dược Thành phố Hồ Chí Minh với 162 trường hợp UTTTL. ADC trung bình tổn thương và mô đối chứng được đo dựa trên ROI. ADC chuẩn hóa (ADCch) được tính bằng cách chia ADC tổn thương cho mô đối chứng.Kết quả: ADC và ADCch tương quan nghịch mạnh với ĐG (ứng với r=-0,66 và r=-0,77
p<
0,05), PSA và đậm độ PSA (đđPSA) tương quan thuận trung bình (ứng với r=0,35 và r=0,33
p<
0,05). AUC phân biệt ĐG6 với ĐG>
6 là 0,837 (ADC), 0,929 (ADCch), 0,701 (PSA) và 0,703 (đđPSA). Khi phân biệt ĐG≤7(3+4) với ĐG≥7(4+3), AUC thay đổi thành 0,847 (ADC), 0,914 (ADCch), 0,723 (PSA) và 0,731 (đđPSA). Với ngưỡng ADCch 0,47, phân biệt ĐG6 và ĐG>
6 có độ chính xác 80,9%, độ nhạy96,8% và độ đặc hiệu 76,7%. Tương tự, phân biệt ĐG≤7(3+4) với ĐG≥7(4+3) với cùng ngưỡng ADCch cho độ chính xác, độ nhạy, độ đặc hiệu lần lượt là 87,0%, 87,3%, 86,9%.Kết luận: ADC cho thấy tương quan với ĐG mạnh hơn và ưu thế hơn PSA trong dự đoán độ ác của UTTTL.Objective: To investigate the correlation between the apparent diffusion coefficient (ADC), prostate-specific antigen (PSA) and Gleason Score (GS)
as well as the performance of these metrics in differentiating between clinically insignificant and significant prostate cancer (Pca).Methods: A retrospective cross-sectional study was carried out at the Ho Chi Minh City Medical University Center, involving 162 patients diagnosed with histologically confirmed prostate carcinoma. Region-ofinterest- based measurements were employed to evaluate the mean ADC of defined lesions and of contralateral normal tissue, then calculated intrapatient normalized ADC (nADC: ADC of lesions divided by ADC of contralateral normal tissue).Result: ADC and nADC exhibited strong negative correlations with GS (r=-0.66 and r=-0.77, p<
0.05
respectively), while PSA and PSA density (PSAd) showed moderate positive correlations (r=0.35 and r=0.33, p<
0.05
respectively). AUC values for distinguishing GS6 from GS>
6 were 0.837 (ADC), 0.929 (nADC), 0.701 (PSA), and 0.703 (PSAd). When distinguishing GS≤7(3+4) and GS≥7(4+3), AUC values changed to 0.847 (ADC), 0.914 (nADC), 0.723 (PSA), and 0.731 (PSAd). AnnADC threshold of 0.47 achieved accurate differentiation between GS6 and GS>
6 with 80.9% accuracy, 96.8% sensitivity, and 76.7% specificity. Similarly, distinguishing GS≤7(3+4) from GS≥7(4+3) with the same nADC threshold resulted in 87.0% accuracy, 87.3% sensitivity, and 86.9% specificity.Conclusion: ADC showed stronger correlation with GS and proved to be a more effective predictor of prostate cancer malignancy comparedto PSA.

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