CT灌注成像预测宫颈鳞癌新辅助化疗后微小淋巴结转移

发布时间：2018-07-18 20:47

【摘要】：目的探讨CT灌注成像预测宫颈鳞癌新辅助化疗后微小淋巴结转移的价值。方法收集在我院接受新辅助化疗并手术的46例宫颈鳞癌患者,根据术后病理是否存在微小淋巴结转移(转移淋巴结短轴径10mm)及短期随访淋巴结转移的情况将其分为无微小淋巴结转移组(n=32)和存在微小淋巴结转移组(n=14),比较其CT灌注参数并分析其诊断价值。结果存在微小淋巴结转移组的肿瘤化疗前肿瘤最大直径、血流量(BF)、血容量(BV)均大于无微小淋巴结转移组(P均0.05);两组间化疗后肿瘤最大直径、渗透性、达峰时间(TTP)差异无统计学意义(P均0.05)。多因素Logistic回归分析结果显示BF、化疗前肿瘤最大直径是新辅助化疗后微小淋巴结转移的独立影响因素。ROC曲线显示BF[AUC=0.86,P0.001,95%CI(0.75,0.96)]较化疗前肿瘤最大直径[AUC=0.70,P=0.02,95%CI(0.54,0.88)]对宫颈鳞癌新辅助化疗后是否存在微小淋巴结转移具有更高的预测价值。结论 CT灌注成像对预测宫颈鳞癌新辅助化疗后微小淋巴结转移具有较高的应用价值。
[Abstract]:Objective to evaluate the value of CT perfusion imaging in predicting minimal lymph node metastasis after neoadjuvant chemotherapy in squamous cell carcinoma of cervix. Methods 46 patients with cervical squamous cell carcinoma underwent neoadjuvant chemotherapy and surgery in our hospital. According to the pathological results of microlymph node metastasis (10mm) and short-term follow-up, the patients were divided into two groups: no microlymph node metastasis group (np32) and minimal lymph node metastasis group (nm14). The CT findings were compared. Perfusion parameters and its diagnostic value were analyzed. Results the maximum diameter, blood flow (BF) and blood volume (BV) of the tumor before chemotherapy in the group with minimal lymph node metastasis were larger than those in the group without minimal lymph node metastasis (P 0.05), the maximum diameter and permeability of the tumor after chemotherapy between the two groups were significantly higher than those in the group without minimal lymph node metastasis (P 0.05). There was no significant difference in peak time (TTP) (P 0.05). Multivariate Logistic regression analysis showed that the maximum diameter of tumor before chemotherapy was an independent influence factor of minimal lymph node metastasis after neoadjuvant chemotherapy. ROC curve showed that BF [AUCU 0.86U P 0.001N 95 CI (0.75U 0.96)] was higher than that before chemotherapy [AUC 0.70 P0.0295 CI (0.540.88)] for neoadjuvant chemotherapy of cervical squamous cell carcinoma. It is more valuable to predict the existence of small lymph node metastasis. Conclusion CT perfusion imaging is valuable in predicting minimal lymph node metastasis after neoadjuvant chemotherapy in squamous cell carcinoma of cervix.
【作者单位】：兰州大学第一医院放射科;
【基金】：2013年甘肃省卫生行业科研计划管理项目(GWGL2013-27)
【分类号】：R737.33;R730.44

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