多层螺旋CT在甲状腺髓样癌术后索拉非尼应用治疗期间中应用研究

发布时间：2018-06-04 22:17

本文选题：MSCT + 甲状腺髓样癌术后　；参考：《中国CT和MRI杂志》2017年04期

【摘要】：目的探究多层螺旋CT(MSCT)在甲状腺髓样癌术后索拉非尼应用治疗期间中应用价值。方法回顾性分析2015年至2016年于我院诊治的38例甲状腺髓样癌术后患者的临床资料。所有患者均因术后出现进行性气急而给予索拉非尼治疗。分析患者的病理学资料、比较患者治疗前后降钙素(CT)及癌胚抗原(CEA)阳性率;通过分析患者用药前、用药8周后、用药32周后的MSCT图像并计算目标病灶最大径线及其缩小率,进而评估MSCT在甲状腺髓样癌术后索拉非尼应用治疗期间中应用价值。结果病理学结果显示,治疗前所有患者癌组织均有CT及CEA弥漫(+)但CK19、Tg表达不定;用药8周后患者癌组织内降钙素CT和CEA阳性率15.79%(6例)和26.32%(10例)用药4周后68.42%(26例)和73.68%(28例)用药前100%(38例)和100%(38例),差异均有统计学意义(P0.05)。MSCT检查结果显示:用药前MSCT图像显示患者的淋巴结转移情况与病理学结果比较无统计学意义(P0.05);用药8周后病灶形态、边界及密度等情况均得到改善,有65.79%(25例)患者病灶边界清楚、密度较均匀高于用药前13例(34.21%)规则、14例(36.84%)清楚(P0.05);用药8周后患者目标病灶最大径线用药4周后用药前,用药8周后患者肿瘤进一步缩小但其缩小率用药4周后,且各用药时间点比较差异均有统计学意义(P0.05)。结论 MSCT图像显示,MTC术后患者应用索拉非尼治疗后病灶形态、边界及密度等情况均得到改善,目标病灶最大径线缩短、瘤体缩小;表明MSCT对评价索拉非尼治疗MTC术后患者的临床疗效具有一定的指导意义。
[Abstract]:Objective to investigate the value of multilayer spiral CTT (MSCT) in the treatment of medullary thyroid carcinoma. Methods the clinical data of 38 patients with medullary thyroid carcinoma treated in our hospital from 2015 to 2016 were analyzed retrospectively. All patients were treated with Solafenib because of progressive shortness of breath. The pathological data of the patients were analyzed to compare the positive rates of calcitonin CTA and carcinoembryonic antigen (CEA) before and after treatment, and the MSCT images of the patients before, after 8 weeks and after 32 weeks were analyzed, and the maximum diameter of the target lesion and its reduction rate were calculated. The value of MSCT in the treatment of medullary thyroid carcinoma was evaluated. Results the pathological results showed that CT and CEA were diffuse in all cancer tissues before treatment, but CK19 Tg expression was not stable. The positive rates of calcitonin CT and CEA in cancer tissues were 15.79 (6 cases) and 26.32 (10 cases) 4 weeks later (68.42 cases) and 73.68% (28 cases). The image showed that there was no significant difference between the lymph node metastasis and pathological results of the patients (P 0.05). The boundary and density were improved, there were 65.79 and 25 cases) the lesion boundary was clear, the density was more uniform than that in 13 cases (34.21), 14 cases (36.84%) were clear (P 0.05), 8 weeks after the treatment, the maximum diameter of the target lesion was 4 weeks before the treatment. After 8 weeks of treatment, the tumor shrank further, but the reduction rate was decreased 4 weeks later, and there were significant differences in the time points between the two groups (P 0.05). Conclusion MSCT images showed that the shape, boundary and density of the lesions were improved after treatment with solafenil, the maximum diameter of the target lesions was shortened and the tumor body was reduced. MSCT is helpful to evaluate the clinical efficacy of solafenil in the treatment of MTC.
【作者单位】：湖北省大冶市人民医院放射科;
【基金】：国家自然科学基金,编号:81071171
【分类号】：R736.1;R730.44

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