| 摘要: |
| 目的 探讨超声造影(CEUS)参数预测局部晚期宫颈癌(LACC)患者同步放化疗(CCRT)早期疗效中的应用价值。方法 选取2021年1月至2022年12月在临沂市肿瘤医院就诊的LACC患者65例,并在治疗前1周内及体外放疗结束后行超声造影(CEUS)检查,均绘制时间-强度曲线(TIC),获得治疗前及体外放疗结束后CEUS参数:达峰时间(TP)、梯度(Grad)、曲线下面积(Area)及峰值强度(PI),同时测量治疗前及体外放疗结束后瘤体最大直径,计算肿瘤消退率。结果 依照实体瘤疗效评价的标准,体外放疗结束后将入组患者按治疗效果分为敏感组和不敏感组,其中敏感组患者53例(81.5%),不敏感组患者12例(18.5%),治疗前和体外放疗结束后肿瘤最大径分别为(60.7±14.6)mm、(31.2±16.9)mm,肿瘤消退率为(49.2±23.2)%。治疗前,敏感组患者Grad及PI值均低于不敏感组患者,差异具有显著的统计学意义(P值均＜0.05)。治疗前Grad及PI值与肿瘤的消退率存在显著的负相关(r值为-0.602、-0.499,P值均＜0.05)。体外放疗结束后,敏感组患者Grad、Area及PI值均较治疗前的数值降低,TP值较治疗前的数值升高,差异具有显著的统计学意义(P值均＜0.05)。体外放疗结束后,敏感组患者Grad、Area及PI值均低于不敏感组患者,TP值高于不敏感组患者,差异具有显著的统计学意义(P值均＜0.05),其中体外放疗结束后Grad及PI值与肿瘤的消退率存在显著的负相关(r值为-0.859、-0.913,P值均＜0.05)。logistic回归分析结果显示治疗前Grad和治疗前PI值均可作为预测LACC患者CCRT早期疗效的独立因素,B、Wald、优势比和P值分别为-2.841、6.496、0.058、0.011和-1.951、7.484、0.142、0.006。治疗前Grad及PI值预测LACC患者CCRT早期疗效的ROC曲线下面积(AUC)分别为:0.802、0.894。结论 治疗前Grad和PI值是预测LACC患者CCRT早期疗效的独立因素,可以作为预测早期疗效的重要参考。 |
| 关键词: 超声造影 局部晚期宫颈癌 同步放化疗 早期疗效 |
| DOI： |
| 投稿时间：2023-04-20修订日期：2023-11-30 |
| 基金项目:临沂市重点研发计划(医学类,编号:2022YX0118) |
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| The application value of contrast-enhanced ultrasound in predicting early therapeutic effect of concurrent chemoradiotherapy for locally advanced cervical cancer |
| guolei,zhouhongzhen,liudemei,zhangtao,lixiumin,wangjinxia,yangzongli |
| (1.Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University 2.Department of Ultrasound,Linyi Tumor Hospital) |
| Abstract: |
| Objective To explore the application value of contrast-enhanced ultrasound (CEUS) parameters in predicting the early therapeutic effect of concurrent chemoradiotherapy (CCRT) in patients with locally advanced cervical cancer (LACC).Methods A total of 65 patients with LACC treated in the Linyi Tumor Hospital from January 2021 to December 2022 were selected. All the patients underwent CEUS within one week before therapy and after the end of external?radiotherapy. The time-intensity curve (TIC) was drawn and analyzed for each patient to obtain CEUS parameters existing before therapy and after the end of external?radiotherapy, wherein the CEUS parameters include time to peak (TP), gradient (Grad), area under the curve (Area) and peak intensity (PI). Meanwhile, the maximum tumor diameters were measured before therapy and after the end of external radiotherapy to calculate the tumour regressive rate.Results According to the response evaluation criteria in solid tumors, the enrolled patients were divided into a sensitive group and an insensitive group, there were 53 patients (81.5%) in the sensitive group and 12 patients (18.5%) in the insensitive group after the end of external radiotherapy, the maximum tumor diameters before therapy and after the end of external radiotherapy were（60.7±14.6) mm and（31.2±16.9) mm respectively, and the tumor regressive rate was（49.2±23.2)%.Before therapy,the values of Grad and PI in the sensitive group were lower than those in the insensitive group, and the differences were statistically significant (all values of P were smaller than 0.05). The pre-therapy Grad and the pre-therapy PI values were in negative correlation with the tumor regressive rate (the values of r were -0.602 and -0.499 respectively, and the values of P are both smaller than 0.05). After the end of the external radiotherapy, in the sensitive group, the values of Grad, Area and PI were all decreased compared with those before therapy, the value of TP was higher than that before therapy, and the differences were statistically significant (all values of P were smaller than 0.05).After the end of the external radiotherapy, the values of Grad, Area and PI in the sensitive group were all lower than those in the insensitive group, the value of TP in the sensitive group was higher than that in the insensitive group,and the differences were statistically significant (all values of P were smaller than 0.05), wherein the values of Grad and PI after the end of the external radiotherapy were in negative correlation with the tumor regressive rate (the values of r were -0.859 and -0.913 respectively, and the values of P were both smaller than 0.05). The logistic regression analysis result showed that Both the pre-therapy Grad and the pre-therapy PI values could be used as the independent factors for predicting the early therapeutic effect of the CCRT in the patients with the LACC, the values of B, Wald, odds ratio and P are -2.841、6.496、0.058、0.011 and -1.951、7.484、0.142、0.006 respectively.The area under the curve (AUC) of the ROC curve of the pre-therapy Grad and the pre-therapy PI values for predicting the early therapeutic effect of the CCRT in the patients with the LACC were 0.802 and 0.894 respectively.Conclusion The pre-therapy Grad and the pre-therapy PI are independent factors for predicting the early therapeutic effect of the CCRT in the patients with the LACC,and can be used as an important reference for predicting the early therapeutic effect. |
| Key words: Contrast-enhanced ultrasound Locally advanced cervical cancer Concurrent chemoradiotherapy Early therapeutic effect |
