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,P<0.001,95%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。
Objective To explore the application value of CT perfusion imaging for predicting the tiny lymph nodes metastasis and micrometastasis of squamous cell carcinoma in cervix after neoadjuvant chemotherapy.Methods The clinical data and CT perfusion parameters of 46 patients with cervical squamous cell carcinoma who underwent neoadjuvant chemotherapy followed by surgery were enrolled in the study.Based on the surgical pathology findings and short-term follow up,the cases were divided into without tiny lymph nodes metastasis（short axle diameter of lymph nodes〈10mm）group（n=32）and with tiny lymph nodes metastasis group（n=14）.All perfusion data were analyzed retrospectively and the diagnostic value were investigated.Results Blood flow（BF）,blood volume（BV）and the maximum diameter of tumor per-chemotherapy in with tiny lymph nodes metastasis group were higher than those in without tiny lymph nodes metastasis group（all P〈0.05）.The differences of the maximum diameter of tumor after chemotherapy,permeability,time to peak（TTP）between two groups were not statistically significant（all P〉0.05）.Multivariate Logistic regression analysis showed BF and the maximum diameter of tumor per-chemotherapy were independent predictors of the tiny lymph nodes metastasis in cervix after neoadjuvant chemotherapy.ROC showed BF（AUC=0.86,P〈0.001,95%CI[0.75,0.96]）had higher predictive value than maximum diameter of tumor per-chemotherapy（AUC=0.70,P=0.02,95%CI[0.54,0.88]）.Conclusion CT perfusion imaging shows the significant predictive value for the tiny lymph nodes metastasis of squamous cell carcinoma in cervix after neoadjuvant chemotherapy.
出处
《中国医学影像技术》
CSCD
北大核心
2017年第3期428-432,共5页
Chinese Journal of Medical Imaging Technology
基金
2013年甘肃省卫生行业科研计划管理项目(GWGL2013-27)
关键词
子宫肿瘤
体层摄影术
X线计算机
化疗法
辅助
淋巴转移
Uterine neoplasms
Tomography
X-ray computed
Chemotherapy
adjuvant
Lymphatic metastasis
