DCE-MRI定量参数与局部进展期宫颈癌患者临床病理特征及疗效的关系  

Relationship between DCE-MRI quantitative parameters and clinicopathological characteristics and efficacy in patients with locally advanced cervical cancer

作　　者：赵琳琳[1] 李小潘[1] 韩晓凤 徐文杰[1] 宋园园 ZHAO Linlin;LI Xiaopan;HAN Xiaofeng;XU Wenjie;SONG Yuanyuan(Department of Imaging Center,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院影像中心,洛阳471000

出　　处：《西南医科大学学报》2024年第3期246-250,共5页Journal of Southwest Medical University

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ202101266)。

摘　　要：目的研究动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)定量参数与局部进展期宫颈癌临床病理特征及同步放化疗疗效的关系。方法选取河南科技大学第一附属医院2017年1月~2022年12月收治的68例局部进展期宫颈癌患者,接受DCE-MRI扫描,分析宫颈癌患者DCE-MRI定量参数[容量转移常数(volume transfer constant,K^(trans))、速率常数(rate constant,K_(ep))、细胞外间隙容积分数(extracellular space volume fraction,V_(e))]与临床病理特征关系;宫颈癌患者均接受同步放化疗,根据放化疗情况,将68例局部进展期宫颈癌患者分为有效组(n=39)与无效组(n=29),对比两组治疗前DCE-MRI定量参数,采用多因素Logistic回归分析探究疗效影响因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析DEC-MRI定量参数对患者疗效预测价值。结果鳞癌患者K^(trans)值较腺癌高(P<0.05);低分化患者K^(trans)、K_(ep)值较中高分化患者高(P<0.05);临床分期≥Ⅲa期患者K^(trans)、K_(ep)、V_(e)值均较<Ⅲa期高(P<0.05);不同肿瘤直径、是否淋巴结转移、是否脉管浸润患者之间DCE-MRI定量参数K^(trans)、K_(ep)、V_(e)值比较无明显差异(P>0.05)。有效组治疗前DCE-MRI定量参数K^(trans)、K_(ep)、V_(e)值均高于无效组(P<0.05)。多因素Logistic回归分析显示,临床分期≥Ⅲa期、K^(trans)、K_(ep)、V_(e)值均是影响局部进展期宫颈癌疗效的危险因素(P<0.05)。K^(trans)、K_(ep)、V_(e)值及三者联合预测疗效的ROC曲线下面积分别为0.962、0.950、0.860、0.997。结论DCE-MRI定量参数与局部进展期宫颈癌患者临床病理特征有一定关系,可作为患者同步放化疗疗效预测指标。Objective To explore the relationship between quantitative parameters of dynamic contrast-enhanced magnetic reso⁃nance imaging(DCE-MRI)and clinicopathological characteristics of locally advanced cervical cancer as well as efficacy of concurrent chemoradiotherapy.Methods 68 patients with locally advanced cervical cancer were selected between January 2017 and December 2020.All patients received DCE-MRI scan,and the relationship between quantitative parameters of DCE-MRI quantitative parameters[volume transfer constant(K^(trans)),rate constant(K_(ep)),extracellular space volume fraction(V_(e))]and clinicopathological characteristics of patients with cervical cancer was analyzed.Patients with cervical cancer received concurrent chemoradiotherapy.The DCE-MRI quanti⁃tative parameters before treatment were compared between the effective group(n=39)and the ineffective group(n=29).Multivariate Logistic regression analysis was used to explore the influencing factors of efficacy.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of DCE-MRI quantitative parameters on efficacy of patients.Results K^(trans)in patients with squa⁃mous cell carcinoma was higher than that in patients with adenocarcinoma(P<0.05),and the K^(trans)and K_(ep)in lowly differentiated pa⁃tients were higher than those in medium-highly differentiated patients(P<0.05),and K^(trans),K_(ep)and V_(e)in patients with clinical stage≥Ⅲa were higher than those in patients with stage<Ⅲa(P<0.05),but there were no statistically significant differences in DCE-MRI quantitative parameters of K^(trans),K_(ep)and V_(e)among patients with different tumor diameters,presence or absence of lymph node metastasis or vascular invasion(P>0.05).The DCE-MRI quantitative parameters K^(trans),K_(ep),and V_(e)in effective group were higher than those in in⁃effective group before treatment(P<0.05).Multivariate Logistic regression analysis showed that clinical stage≥Ⅲa,K^(trans),K_(ep),and V_(e)were all risk factors affecting the ef

关 键 词：动态对比增强磁共振成像 宫颈癌 局部进展期 同步放化疗 预后 

分 类 号：R737.33[医药卫生—肿瘤] R445[医药卫生—临床医学]