ADC值对子宫内膜非典型增生及子宫内膜癌保留生育能力治疗疗效评估  

The Value of ADC for Evaluating the Efficacy of Fertility-Sparing Treatment for Atypical Endometrial Hyperplasia and Endometrial Cancer

作　　者：刘明明[1] 梁宇霆[1] 赵维敬[1] LIU Mingming;LIANG Yuting;ZHAO Weijing(Department of Radiology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100006,P.R.China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院放射科,北京100006

出　　处：《临床放射学杂志》2023年第10期1655-1658,共4页Journal of Clinical Radiology

基　　金：首都医科大学附属北京妇产医院科技创新及转化专项项目(编号:FCYYLC202201)。

摘　　要：目的探讨表观扩散系数(ADC)值对子宫内膜非典型增生及子宫内膜癌保留生育能力治疗疗效评估。方法回顾性搜集2015年1月至2021年12月保留生育能力治疗的子宫内膜非典型增生及子宫内膜癌患者资料,所有患者分别于治疗后3个月和6个月行MRI和宫腔镜复查,MRI早于宫腔镜。以宫腔镜病理结果为标准,重复测量方差分析法比较治疗前、治疗后3个月、治疗后6个月病变及相应部位内膜ADC值。结果子宫内膜癌患者5例,治疗前、治疗后3个月和治疗后6个月的肿瘤及治疗后相应部位内膜ADC值分别为(0.8±0.06)×10^(-3)mm^(2)/s、(1.1±0.03)×10^(-3)mm^(2)/s、(1.2±0.08)×10^(-3)mm^(2)/s,三组间ADC值差异均有统计学意义(P<0.05)。子宫内膜非典型增生患者5例,治疗前、治疗后3个月和治疗后6个月的内膜ADC值分别为(1.1±0.06)×10^(-3)mm^(2)/s、(1.1±0.01)×10^(-3)mm^(2)/s、(1.3±0.09)×10^(-3)mm^(2)/s,治疗后3个月和治疗后6个月较治疗前ADC值差异无统计学意义(P>0.05),但治疗后6个月较治疗后3个月ADC值差异有统计学意义(P<0.05)。结论ADC值可用于子宫内膜癌和子宫内膜非典型增生保留生育能力治疗疗效评估,在治疗后6个月评估更有意义。Objective To investigate the efficacy of ADC value in evaluating fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer.Methods The data of patients with atypical endometrial hyperplasia and early-stage endometrial cancer undergoing fertility-sparing therapy from January 2015 to December 2021 was retrospectively collected.All patients underwent MRI and hysteroscopy review at 3 and 6 months after treatment,respectively.MRI review was earlier than hysteroscopy.Taking the pathological results of hysteroscopy as the standard,repeated measures analysis of variance was used to compare the ADC values of lesions before treatment,and corresponding parts of the endometrium for 3 months and 6 months after treatment.Results There were 5 patients with endometrial cancer,the ADC values of tumor before treatment,3 months after treatment and 6 months after treatment were respectively(0.8±0.06)×10(-3)mm^(2)/s,(1.1±0.03)×10(-3)mm^(2)/s and(1.2±0.08)×10(-3)mm^(2)/s,the difference of ADC value among the three groups was statistically significant(P<0.05).There were 5 patients with endometrial hyperplasia,the ADC values of endometrium before treatment,3 months after treatment and 6 months after treatment were respectively(1.1±0.06)×10(-3)mm^(2)/s,(1.1±0.01)×10(-3)mm^(2)/s and(1.3±0.09)×10(-3)mm^(2)/s.There was no significant difference of ADC value between 3 months and 6 months after treatment compared with before treatment(P>0.05),but the ADC value of 6 months after treatment was higher than that of 3 months after treatment,the difference was statistically significant(P<0.05).Conclusion The ADC value can be used to evaluate the efficacy of fertility-sparing treatment for endometrial cancer and atypical endometrial hyperplasia at 6 months after treatment.

关 键 词：子宫内膜癌 子宫内膜增生 表观扩散系数 生育 

分 类 号：R737.33[医药卫生—肿瘤]