title: Grading of uterine cervical cancer by using the ADC difference value and its correlation with microvascular density and vascular endothelial growth factor.
abstract: OBJECTIVE
  To investigate the application value of the ADC(difference) value in evaluating the pathological grade of uterine cervical cancer and to analyse the correlations among microvascular density (MVD), vascular endothelial growth factor (VEGF) expression and maximum ADC(difference) value.
  
  
  METHODS
  Fifty-six patients with uterine cervical cancer were included in this prospective study. All underwent conventional MRI and DWI. MVD and VEGF were evaluated by immunohistochemical staining with anti-CD34 and anti-VEGF, respectively.
  
  
  RESULTS
  Maximum ADC(difference) value and MVD count showed statistical differences among different pathological grades (P < 0.001, P < 0.001). There was a significant positive linear correlation between the maximum ADC(difference) value and pathological tumour grade (P < 0.001), and also between MVD count and pathological tumour grade (P < 0.001). No significant differences were found between the level of VEGF expression and pathological tumour grade (P = 0.222). The maximum ADC(difference) value correlated positively with both the MVD count and the level of VEGF expression (P < 0.001, P < 0.001).
  
  
  CONCLUSIONS
  Quantitative analysis of maximum ADC(difference) value of uterine cervical cancer may represent the grade of tumour differentiation and provide valuable information on tumour microcirculation and perfusion, thus allowing a promising new method of non-invasively assessing the pathological grade, which could serve as a substitution for assessing tumour angiogenesis.
authors.affiliation: Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, People's Republic of China. liuying811126@yahoo.com.cn
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Zhaoxiang
authors.initials: Z
authors.lastname: Ye
authors.forename: Haoran
authors.initials: H
authors.lastname: Sun
authors.forename: Renju
authors.initials: R
authors.lastname: Bai
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D055806:Microvessels / Q000473:pathology*; D008875:Middle Aged; D060787:Neoplasm Grading; D009389:Neovascularization, Pathologic / Q000150:complications / Q000378:metabolism* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014594:Uterine Neoplasms / Q000150:complications / Q000378:metabolism* / Q000473:pathology*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D042461:Vascular Endothelial Growth Factor A