摘要
目的:评估VI-RADS评分系统的准确性，以及肿瘤的定量参数对VI-RADS评分系统评估膀胱癌的辅助价值。方法:回顾性分析泰州市人民医院79例经病理证实的膀胱癌病例资料，以病理结果为标准，分析VI-RADS评估膀胱癌肌层浸润的准确性。按照病理结果有无肌层浸润将患者分为两组，测量膀胱癌病灶的表观扩散系数（ADC）值、肿瘤-膀胱壁接触长度（TCL）、肿瘤最大径、病灶周长，分析每个定量参数对肌层浸润的诊断效能，以及与肿瘤分期的相关性。结果:VI-RADS评分诊断浸润性膀胱癌的ROC曲线下面积（AUC）为0.925（95%CI：0.863～0.986，P<0.05），取≥4分作为诊断标准时，约登指数最大为0.651，敏感度为68.4%，特异度为96.7%；膀胱癌的ADC值、TCL、肿瘤最大径、病灶周长诊断肌层浸润的AUC分别为0.822，0.865，0.799，0.796，敏感度为76.5%，70.6%，70.6%，76.5%，特异度为84.9%，94.3%，90.6%，90.6%，VI-RADS评分联合各参数诊断肌层浸润的AUC为0.980，敏感度100%，特异度86.8%；膀胱癌的ADC值、TCL、肿瘤最大直径、病灶周长与肿瘤分期具有明显相关性。结论:膀胱癌的ADC值、TCL、肿瘤最大径、病灶周长可以一定程度诊断膀胱癌有无肌层浸润，对VI-RADS评分系统进行补充其中TCL的诊断价值最大。
Abstract
Objective:To assess the accuracy of the VI-RADS scoring system and the complementary value of quantitative parameters of tumors to the VI-RADS scoring system.Methods:A retrospective analysis was performed on 79 cases of pathologically confirmed bladder cancer in Taizhou People's Hospital. Based on pathological results, VI-RADS was analyzed to assess the accuracy of myodermal infiltrates in bladder cancer. According to the pathological results, the patients were divided into two groups, the apparent diffusion coefficient (ADC) value of the bladder cancer lesion, the maximum tumor diameter, the tumor-bladder wall contact length (TCL), the lesion circumference were measured, the diagnostic efficacy of each quantitative parameter on the muscle infiltration, and the correlation with tumor staging was analyzed.Results:The area under the ROC curve (AUC) of VI-RADS score for the diagnosis of invasive bladder cancer was 0.925 (95%CI: 0.863-0.986, P<0.05), and when the ≥4 score was taken as the diagnostic criterion, the Yourden index was up to 0.651, the sensitivity was 68.4%, and the specificity was 96.7%. The ADC value, TCL, maximum tumor diameter, lesion circumference of bladder cancer for diagnosing muscle invasion had an AUC of 0.822, 0.865, 0.799, 0.796, the sensitivity was 76.5%, 70.6%, 70.6%, 76.5%, specificity was 84.9%, 94.3%, 90.6%, 90.6%, respectively. The AUC of VI-RADS score combined with various parameters to diagnose myolayer infiltration was 0.980, sensitivity was 100%, specificity was 86.8%. The ADC value, TCL, maximum diameter of the tumor, and lesion circumference of bladder cancer were significantly correlated with tumor stage.Conclusion:The ADC value, TCL, maximum diameter of the tumor, and circumference of the lesion of bladder cancer can diagnose whether there is muscle layer invasion of bladder cancer to a certain extent, and supplement the VI-RADS scoring system, and the diagnostic value of TCL is the greatest among the parameters.
万方数据