影像科学与光化学 ›› 2020, Vol. 38 ›› Issue (1): 59-66.DOI: 10.7517/issn.1674-0475.190706

• 综述与论文 • 上一篇    下一篇

超声造影参数对宫颈癌新辅助化疗疗效的评估价值

纪亚梅, 沈翠   

  1. 鄂东医疗集团 黄石市妇幼保健院 超声科, 湖北 黄石 435003
  • 收稿日期:2019-07-05 出版日期:2020-01-15 发布日期:2020-01-15

The Value of Contrast-enhanced Ultrasound Parameters in Evaluating the Efficacy of Neoadjuvant Chemotherapy for Cervical Cancer

JI Yamei, SHEN Cui   

  1. Department of Ultrasound, Huangshi Maternity and Children's Health Hospital, Edong Healthcare Group, Huangshi 435003, Hubei, P. R. China
  • Received:2019-07-05 Online:2020-01-15 Published:2020-01-15

摘要: 本文对超声造影参数对宫颈癌新辅助化疗疗效的评估价值进行了分析。选取2016年3月~2018年3月本院宫颈癌新辅助化疗患者200例,所有患者均给予紫杉醇+顺铂(TP)方案化疗治疗并行超声造影检查,分析超声造影参数:开始增强时间(AT)、达峰时间(TTP)、峰值强度(PI)、基础强度(BI),以及增强强度(EI)对新辅助化疗疗效的评估价值。结果显示,完全缓解(CR)12例、部分缓解(PR)136例、病情稳定(SD)36例、恶化(PD)16例,化疗无效者148例,有效率74.00%。化疗无效者和有效者BI、EI化疗前后比较,无效者化疗前后AT、TTP、PI比较,差异无统计学意义(P>0.05),有效者化疗后:AT、TTP明显低于化疗前,PI明显高于化疗前;无效者化疗后:AT、TTP明显高于有效者,PI明显低于有效者,有效者AT、TTP下降值及PI升高值明显高于无效,差异有统计学意义(P<0.05)。ROC曲线分析显示评估宫颈癌新辅助化疗有效性的敏感度、特异度、准确度:AT下降值以>1.0 s为临界值时,为87.84%、80.77%、86.00%,TTP下降值以>1.5 s为临界值时,为89.19%、84.62%、88.00%,PI升高值以>2.0 dB为临界值时,为85.14%、76.92%、83.00%,三者联合时为97.30%、96.15%、97.00%,三者联合时明显高于三者单独时,差异有统计学意义(P<0.05)。本文证实了超声造影参数中AT、TTP、PI与宫颈癌新辅助化疗疗效有关,并可作为评估患者化疗有效性的指标,且三者联合时评估效能更佳。

关键词: 超声造影, 参数, 宫颈癌, 新辅助化疗, 疗效, 评估

Abstract: The value of contrast-enhanced ultrasound parameters in evaluating the efficacy of neoadjuvant chemotherapy for cervical cancer was analyzed in this study. 200 patients with cervical cancer undergoing the neoadjuvant chemotherapy from March 2016 to March 2018 in our hospital were selected as the subjects of this study, all patients were given paclitaxel + cisplatin (TP) regimen chemotherapy and the contrast-enhanced ultrasound, the value of contrast-enhanced ultrasound parameters[initial enhancement time (AT), time to peak (TTP), base intensity (BI), peak intensity (PI), enhancement intensity (EI)] in evaluating the efficacy of neoadjuvant chemotherapy were analyzed. The results showed that there were 12 cases of complete remission (CR), 136 cases of partial remission (PR), 36 cases of stable disease (SD), 16 cases of deterioration (PD) and 148 cases of chemotherapy effective, the effective rate was 74.00%. The comparison of the BI and EI between the effective patients and the ineffective patients before and after chemotherapy, the comparison of the AT, TTP, PI in the ineffective patients before and after chemotherapy, the difference was not statistically significant (P>0.05), the AT and TTP after chemotherapy in the effective patients were significantly lower than those before chemotherapy, the PI after chemotherapy in the effective patients were significantly higher than those before chemotherapy, the AT and TTP after chemotherapy in the ineffective patients were significantly higher than those in the effective patients, the PI after chemotherapy in the ineffective patients were significantly lower than those in the effective patients, the AT and TTP decreased value, PI increased value were significantly higher than those in the ineffective group, the difference was statistically significant (P<0.05). The ROC curve analysis of the sensitivity, specificity, accuracy of evaluating the efficacy of neoadjuvant chemotherapy for cervical cancer showed that, the combination of the three methods were statistically significant higher than the three alone, the difference was statistically significant (P<0.05). This study confirms that, contrast-enhanced ultrasound parameters AT, TTP, PI are related to the efficacy of neoadjuvant chemotherapy for cervical cancer, and can be used as an index to evaluate the effectiveness of chemotherapy, and the combination of the three is more effective.

Key words: contrast-enhanced ultrasound, parameters, cervical cancer, neoadjuvant chemotherapy, efficacy, evaluate