CT联合MRI子宫内膜癌分期诊断与术后VEGF-C水平观察  

Staging Diagnosis of Endometrial Cancer by CT plus MRI and the Postoperative Level of VEGF-C

作　　者：党勇 段钊[2] DANG Yong;DUAN Zao(CT Center,Central Hospital of Tongchuan Mining Bureau,Tongchuan Shannxi 727000;Dept. of Obstetrics and Gynecology,The 2nd Affiliated Hospital of Xi’an Jiaotong University,xi’an Shannxi 710004,China)

机构地区：[1]陕西省铜川矿务局中心医院CT室,陕西铜川727000 [2]西安交通大学医学院第二附属医院妇产科,陕西西安710004

出　　处：《昆明医科大学学报》2017年第6期124-129,共6页Journal of Kunming Medical University

基　　金：陕西省自然科学基金资助项目(2013JM4012)

摘　　要：目的探讨CT联合MRI对子宫内膜癌术前分期诊断的临床应用价值,同时结合对术后VEGF-C表达水平的观察以判断子宫内膜癌的恶性程度.方法随机选取铜川市矿务局中心医院妇瘤科2015年1月至2016年1月通过手术病理检查确诊的70例子宫内膜癌患者作为研究对象,所有研究对象均进行CT检查、MRI检查以及CT联合MRI检查,以手术病理分期为标准,将单纯CT检查和单纯MRI检查作为对照,比较CT、MRI及CT联合MRI的诊断准确率,分析CT和MRI联合检查在晚期子宫内膜癌术前分期的准确性.同时对所有研究对象术后的病理切片采用免疫组织化学法测定组织内VEGF的表达,观察术后VEGF-C的表达水平,以判断子宫内膜癌的恶性程度.结果 70例子宫内膜癌患者的单纯CT、单纯MRI及CT联合MRI的术前分期术前诊断准确率分别为59.4%、65.7%和92.1%,CT联合MRI检查的诊断准确率显著高于单纯CT和单纯MRI检查(P<0.05),差异具有统计学意义.观察到VEGF-C在不同级别子宫内膜癌组织中的表达水平具有统计学意义,并与CT联合MRI的术前分期呈现正相关性.结论 CT联合MRI检查与单纯CT检查和单纯MRI检查比较在子宫内膜癌的术前分期术前诊断准确率显著增高,且与术后VEGF-C的表达水平呈正相关性,因此可以通过CT联合MRI检查结合肿瘤生物学指标VEGF-C的表达情况对子宫内膜癌患者进行术前分期诊断并推测其恶性程度,增加了对子宫内膜癌的临床评估和预后的科学性.Objective To explore the clinical application value of CT plus MRI in the staging diagnosis of endometrial cancer,and to evaluate the malignancy of cancer according to the postoperative level of VEGF-C.Methods A total of70pathologically conformed endometrial cancercases were randomly selected.All patients underwent CT,MRI,and CT plus MRI examinations.Based on the staging confirmed by surgery,the accuracy rates of diagnosis of CT,MRI,and CT plus MRI were compared.The level of postoperative VGEF-C was observed to determine the malignancy of the cancer.Results The accuracy rate of diagnosis of CT,MRI,and CT plus MRI before surgery was59.4%,65.7%and92.1%,respectively.The rate of CT plus MRI was significantly higher than the rate of the other two examinations(P<0.05).In addition,There was significant difference in the level of VEGF-C between endometrial cancers of differentstages.A positive correlation was observed between preoperative staging determined by CT plus MRI examination and the level of VEGF-C.Conclusion CT plus MRI examination can produce high accuracy rate of staging diagnosis,which is positively correlated with the postoperative level of VEGF-C.Therefore,CT plus MRI examinationcan predict the malignancy of endometrial cancer,which is helpful for the clinical assessment and prognosis of endometrial cancer.

关 键 词：子宫内膜癌 CT MRI 分期诊断 VEGF-C 

分 类 号：R737.33[医药卫生—肿瘤]