三维能量多普勒超声对宫颈鳞癌分期化疗疗效的评估价值  

The Value of Three-Dimensional Power Doppler Ultrasound in Efficacy Evaluation of Chemotherapy to Stage Cervical Squamous Cell Carcinoma

作　　者：唐琴[1] 骆迎春[1] 周启昌[2] 唐小玲[1] 杨红琳[1] Tang Qin;Luo Yingchun;Zhou Qichang;Tang Xiaoling;Yang Honglin(Department of Ultrasound,Hunan Provincial Maternal and Child Health Care Hospital,Changsha 410028,China;Department of Ultrasound,The Second Xiangya Hospital of Central South University,Changsha 410011,China)

机构地区：[1]湖南省妇幼保健院超声科,长沙市410028 [2]中南大学湘雅二医院超声科,长沙市410011

出　　处：《中国超声医学杂志》2023年第1期62-65,共4页Chinese Journal of Ultrasound in Medicine

基　　金：湖南省卫生健康委科研计划项目(No.20200425);湖南省出生缺陷协同防治科技重大专项(No.2019SK1010)。

摘　　要：目的 探讨三维能量多普勒超声(3D-PDU)评估宫颈鳞癌化疗疗效的应用价值。方法 选择65例经病理检查证实为宫颈鳞癌的患者,其中IB期25例,ⅡA期19例,ⅡB期21例,均予以紫杉醇联合卡铂化疗,分别在化疗前、后一周进行3D-PDU检查,获取病灶的血管化指数(VI)、血流指数(FI)、血管化血流指数(VFI),并计算化疗后VI、FI、VFI的下降百分率,比较化疗有效组和无效组的参数差异。采用Logistic回归及受试者工作特征(ROC)曲线分析3D-PDU评估化疗疗效的诊断效能。结果 随着宫颈鳞癌临床分期级别升高,血流灌注参数VI、FI、VFI逐渐升高,化疗后VI、FI、VFI的下降百分率降低,P<0.05。建立Logistic回归模型,联合ROC曲线分析3D-PDU诊断化疗疗效的曲线下面积(AUC)为0.93,灵敏度为90.01%,特异度为80.01%。结论 紫杉醇联合卡铂化疗对早期宫颈鳞癌患者的疗效显著,能有效抑制肿瘤血管的生成。3D-PDU能检测宫颈鳞癌化疗后肿瘤血流灌注的变化情况,对疗效的评估具有较高的应用价值。Objective To explore the value of three-dimensional power Doppler ultrasound in evaluating the chemotherapy efficacy for cervical squamous cell carcinoma.Methods 65 patients with cervical squamous cell carcinoma confirmed by pathological examination in our hospital,including 25 patients in stage IB,19 patients in stage ⅡA and 21 patients in stage ⅡB,were treated by taxol combined with carboplatin chemotherapy.Three-dimensional power Doppler ultrasonography was performed one week before and after chemotherapy respectively.The vascularization index(VI),blood flow index(FI) and vascularized blood flow index(VFI) of the lesions were obtained,and the decrease percentage of VI,FI and VFI after chemotherapy was calculated and compared between the effective group and the ineffective group.Logistic regression and receiver operating characteristic(ROC) curve were used to analyze the diagnostic efficacy of 3 D-PDU in evaluating the chemotherapy efficacy.Results With the increase of clinical stage level of cervical squamous cell carcinoma,the blood perfusion parameters VI,FI and VFI increased gradually,the decrease percentage of VI,FI and VFI decreased(P<0.05).Logistic regression model was established based on the decrease percentage of VI,FI and VFI after chemotherapy,combined with ROC curve analysis,the area under the curve(AUC) of 3 D-PDU in the diagnosis of chemotherapy efficacy was 0.93,the sensitivity was 90.01%,and the specificity was 80.01%.Conclusions Taxol combined with carboplatin chemotherapy has a significant curative effect on patients with early cervical squamous cell carcinoma,and can effectively inhibit tumor angiogenesis.3 D-PDU can detect the changes of tumor blood flow before and after chemotherapy for cervix squamous cell carcinoma,and has high application value for the evaluation of efficacy.

关 键 词：三维能量多普勒超声 宫颈鳞癌 疗效 血流灌注 紫杉醇 卡铂 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]