鼻咽癌颈部转移淋巴结诱导化疗后血供变化预测近期放化疗效应的研究  

Blood Supply Changes after Induction Chemotherapy of Metastatic Cervical Lymph Nodes from Nasopharyngeal Carcinoma to Predict Short-term Effect of Chemoradiotherapy

作　　者：朱雪莲[1] 周丽明[2] 陈顺平[1] 赵亮[1] 

机构地区：[1]温州医学院附属第一医院超声科,325000 [2]浙江大学医学院附属第二医院超声科,杭州310009

出　　处：《医学研究杂志》2012年第11期148-151,共4页Journal of Medical Research

摘　　要：目的观察鼻咽癌颈部转移性淋巴结诱导化疗后的血供变化及序贯放疗后的退缩率,探讨诱导化疗后的血供变化预测近期放化疗效应的价值。方法选取40例病理证实的鼻咽癌初治患者及其颈部转移性淋巴结65枚,以转移性淋巴结化疗前后的血供变化将其分为血供减少组、血供改善组和血供无变化组,二维及彩色多普勒超声观察转移性淋巴结治疗前的大小、纵横比、收缩期峰值流速(PSV)、阻力指数(RI)以及诱导化疗后的血供变化及序贯放疗后退缩率,计算诱导化疗后的血供变化与近期放化疗效应间的相关性。结果鼻咽癌颈部转移淋巴结序贯放疗后的退缩率在血供减少组、血供改善组及血供无变化组3组间依次降低,组间差异有统计学意义(P<0.05);诱导化疗后的血供变化与序贯放疗后退缩率间相关性良好(r=0.553,P=0.000)。结论彩色多普勒超声对鼻咽癌颈部转移性淋巴结诱导化疗后血供变化的监测可作为初步预测近期放化疗效果的指标之一。Objective To observe the blood supply changes after induction chemotherapy and regression rate of sequential chemora- diotherapy of metastatic cervical lymph nodes in nasopharyngeal carcinoma, and to get the predictive value of two parameters mentioned a- bove. Methods Forty patients with sixty - five metastatic cervical lymph nodes which were confirmed as nasopharyngeal carcinoma by bi- opsy were studied by two - dimensional echocardiography and color Doppler flow imaging. According to the pattern of blood supply changes after induction chemotherapy, lymph nodes were divided into three groups, parameters of lymph nodes were recorded before treatment, such as size, long- short axis ratio, peak systolic velocity （PSV）, resistivity index （RI）, blood supply, regression rate, and the blood supply changes after induction chemotherapy, regression rate of sequential chemoradiotherapy were calculated, and the correlation between the blood supply changes after induction chemotherapy and the regression rate of sequential chemo radiotherapy were studied. Results The difference of regression rate after sequential chemoradiotherapy was statistically significant （ P 〈 0.05 ）. The blood supply changes af- ter induction chemotherapy related well with the regression rate of sequential chemoradiotherapy（ r = O. 553,P = 0. 000）. Conclusion The blood supply changes of metastatic cervical lymph nodes from nasopharyngeal carcinoma after induction chemotherapy can be one of the predictors of short - term effect of chemoradiotherapy.

关 键 词：鼻咽癌 颈部转移性淋巴结 诱导化疗 血供变化 近期放化疗效应 

分 类 号：R739.63[医药卫生—肿瘤]