DWI检查的ADC值与胰腺癌伴肝转移患者治疗预后的关系

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摘要目的探讨弥散加权成像(DWI)检查的表观扩散系数(ADC)值与胰腺癌伴肝转移患者治疗预后的关系。方法回顾性分析2019-10至2022-01于海军安庆医院收治的经病理学检验确诊为胰腺癌伴肝转移的96例患者,行常规MRI联合增强扫描。收集患者的相关资料,分析患者DWI的ADC值的水平,对患者进行随访,以术后12个月为随访止点,根据患者的存活情况,将患者分为存活组(n=63)和死亡组(n=33),采用多因素Logistic回归分析影响患者治疗预后的独立影响因素。结果单因素分析结果显示,两组患者的年龄、胰肿瘤最大直径、肝转移瘤直径、肝转移瘤数目、淋巴结转移情况、肿瘤分化程度、Alb、ADC值均存在统计学差异(P<0.05),而两组患者的性别、BMI、肿瘤位置、神经侵犯情况、Hb、PLT差异并无统计学意义(P>0.05)。多因素分析结果显示,肝转移瘤数目[OR=2.702,95%CI(1.340,5.450)]、血管侵犯[OR=1.906,95%CI(1.052,3.452)]、肿瘤分化程度[OR=1.269,95%CI(1.025,1.571)]、ADC值[OR=0.422,95%CI(0.216,0.824)]均为影响胰腺癌伴肝转移患者治疗预后的独立影响因素(P<0.05),其中ADC值为独立保护性因素,其余皆为独立危险因素。结论肝转移瘤数目、淋巴结转移、肿瘤分化程度、ADC值均为影响胰腺癌伴肝转移患者治疗预后的独立影响因素,临床可根据相应情况进行治疗方案的调整与完善。

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	杨珊珊
	沈松柏
	胡良先
	华双一

关键词 ：胰腺癌伴肝转移, 增强磁共振检查, 表观扩散系数, 预后

Abstract：Objective To explore the correlation between the apparent diffusion coefficient (ADC) value of diffusion weighted imaging (DWI) and the prognosis of of pancreatic cancer patients with liver metastasis.Methods A retrospective analysis was made on 96 patients with pancreatic cancer with liver metastasis confirmed by pathology in Anqing Hospital of PLA Navy from October 2019 to January 2022, and all the patients were treated with conventional MRI combined with enhanced scanning. The relevant data of the patients were collected, the ADC value of the patients' DWI was analyzed, and the patients were followed up for 12 months. Based on the survival status of the patients, they were divided into survival group (n=63) and death group (n=33), and multivariate logistic regression analysis was used to analyze the independent influencing factors that affected the treatment prognosis of the patients.Results Univariate analysis showed that there were statistical differences in age, maximum diameter of pancreatic tumor, diameter of liver metastases, number of liver metastases, lymph node metastasis, tumor differentiation, Alb and ADC values between the two groups (P<0.05), while there was no significant difference in gender, BMI, tumor location, nerve invasion, Hb, or PLT between the two groups (P>0.05). The results of multivariate analysis showed that the number of liver metastases [OR=2.702,95%CI(1.340,5.450)], vascular invasion [OR=1.906, 95%CI (1.052, 3.452)], tumor differentiation [OR=1.269,95%CL(1.025,1.571)] and ADC value [OR=0.422, 95%CI (0.216,0.824)] were independent influencing factors on the prognosis of patients with pancreatic cancer with liver metastasis (P<0.05), in which the ADC value was an independent protective factor, and the rest were independent risk factors.Conclusions The number of liver metastases, lymph node metastasis, degree of tumor differentiation and ADC value are independent factors for the prognosis of pancreatic cancer patients with liver metastases. Clinical treatment plans can be adjusted and improved according to the corresponding situation.

Key words： pancreatic cancer with liver metastasis gadopentetate-enhanced magnetic resonance imaging apparent diffusion coefficient prognosis

收稿日期: 2023-08-14

ZTFLH:	R445.2
	R735.9

基金资助:安徽省卫生健康软科学研究项目(2020WR04008)

通讯作者: 华双一,E-mail:huasy116@163.com

作者简介: 杨珊珊,本科学历,主治医师。

引用本文:

杨珊珊, 沈松柏, 胡良先, 华双一. DWI检查的ADC值与胰腺癌伴肝转移患者治疗预后的关系[J]. 武警医学, 2024, 35(2): 135-139. YANG Shanshan, SHEN Songbai, HU Liangxian, HUA Shuangyi. Relationship between ADC value of DWI examination and prognosis of pancreatic cancer patients with liver metastasis. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(2): 135-139.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2024/V35/I2/135

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