目的：评价舌部病灶与病灶周围正常腺体表观弥散系数（ADC）的比值对于舌癌的诊断、病理分级、分期的应用价值及相关性。方法：收集2017年3月—2019年3月吉林大学中日联谊医院经手术病理证实的60例舌部病变患者的资料，术前行常规MRI及DWI序列扫描，测量瘤体及瘤体周围正常腺体的ADC值并计算出ADC比值，将其与术后病理结果进行对照分析。结果：①舌癌40例，舌良性病灶20例，舌癌对应的ADC比值为-0.13±0.17，舌良性病灶对应的ADC比值为0.09±0.10，二者比值间差异有统计学意义（t=5.129，P<0.05）。②高分化组的ADC比值为0.02±0.07，中分化组的ADC比值为-0.14±0.17，低分化组的ADC比值为-0.26±0.09，三组间比较差异有统计学意义（F=3.593，P=0.047）。③晚期舌癌组（T3+T4）的ADC比值（-0.20±0.13）低于早期舌癌组（Tis+T1+T2）的ADC比值（0.00±0.17）（t=3.314，P=0.03<0.05），T4与T1及T2比较差异有统计学意义（P<0.05），其他两两比较无显著差异（P>0.05）。结论：ADC比值能够为舌良恶性病灶的鉴别诊断以及舌癌的病理分级、分期提供参考依据，具有重要的临床指导意义。
Abstract
Objective: To evaluate the value and correlation of the ratio of apparent diffusion coefficient(ADC) of tongue lesions and surrounding normal glands in the diagnosis, pathological grading and staging of tongue cancer. Methods: Sixty patients with tongue lesions confirmed by surgical pathology in China-Japan Union Hospital of Jilin University from March 2017 to March 2019 were collected. Routine MRI and DWI scanning were performed before operation, and the ADC values of lesions and surrounding glands were measured and the ADC ratio was calculated. Results: ①There were 40 cases of tongue cancer and 20 cases of tongue benign lesions. The ADC ratio of tongue cancer was -0.13±0.17 and that of tongue benign lesions was 0.09±0.10, and the difference between the two ratios was statistically significant(t=5.129, P<0.05). ②The ADC ratio of the highly differentiated group was 0.02±0.07, the ADC ratio of the moderately differentiated group was -0.14±0.17, and the ADC ratio of the low-differentiated group was -0.26±0.09. There were statistically significant differences among the three groups(F=3.593, P=0.047). ③The ADC ratio of the advanced tongue cancer group(T3+T4) was -0.20±0.13, which was lower than that of the early tongue cancer group(Tis+T1+T2), the ADC ratio of the early tongue cancer group was 0.00±0.17(t=3.314, P=0.03<0.05). The difference between T4 and T1 and T2 was statistically significant(P<0.05), while no significant difference was found in other pairwise comparisons(P>0.05). Conclusion: The apparent diffusion coefficient ratio can provide reference for the differential diagnosis of benign and malignant tongue lesions and the pathological classification and staging of tongue cancer, and has important clinical significance.
关键词
舌肿瘤 /
磁共振成像
Key words
Tongue neoplasms /
Magnetic resonance imaging
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基金
吉林省卫生与健康技术创新项目（2018J078）。
