超声造影预测局部晚期宫颈癌同步放化疗早期疗效的临床价值
Clinical value of contrast-enhanced ultrasound in predicting early therapeutic effect of concurrent chemoradiotherapy for locally advanced cervical cancer
郭磊 1周洪珍 2刘德梅 3张涛 2李秀敏 3王金霞 4杨宗利1
作者信息
- 1. 266003 山东省青岛市,青岛大学附属医院腹部超声科
- 2. 临沂市肿瘤医院超声医学科
- 3. 临沂市肿瘤医院妇瘤科
- 4. 高密市人民医院超声科
- 折叠
摘要
目的 探讨超声造影(CEUS)预测局部晚期宫颈癌(LACC)患者同步放化疗(CCRT)早期疗效的临床价值.方法 选取临沂市肿瘤医院收治的LACC患者65例,于治疗前1周内及体外放疗结束后分别进行CEUS检查,通过定量分析时间-强度曲线(TIC)获得达峰时间(TP)、梯度(Grad)、曲线下面积(Area)及峰值强度(PI);测量治疗前后瘤体最大径,计算肿瘤消退率.体外放疗结束后根据治疗效果分为敏感组53例和不敏感组12例,比较两组上述参数的差异.采用Spearman相关分析法分析CEUS参数与肿瘤消退率的相关性;二元Logistic回归分析筛选预测LACC患者CCRT早期疗效的影响因素;绘制受试者工作特征(ROC)曲线分析其预测效能.结果 65例LACC患者治疗前和体外放疗结束后瘤体最大径分别为(60.7±14.6)mm、(31.2±16.9)mm,肿瘤消退率为(49.2±23.2)%.敏感组治疗前Grad、PI均低于不敏感组,差异均有统计学意义(均P<0.05);敏感组体外放疗结束后Grad、Area及PI均低于不敏感组,TP高于不敏感组,差异均有统计学意义(均P<0.001).敏感组体外放疗结束后Grad、Area及PI均较治疗前降低,TP较治疗前升高,差异均有统计学意义(均P<0.05).相关性分析显示,治疗前Grad、PI与肿瘤消退率均呈负相关(r=-0.602、-0.499,均P<0.05);体外放疗结束后Grad、PI与肿瘤消退率均呈负相关(r=-0.859、-0.913,均P<0.05).二元Logistic回归分析显示,治疗前Grad、PI均为预测LACC患者CCRT早期疗效的独立影响因素(均P<0.05).ROC曲线分析显示,治疗前Grad、PI预测LACC患者CCRT早期疗效的曲线下面积分别为0.802、0.894.结论 CEUS在预测LACC患者CCRT早期疗效中有一定的临床价值.
Abstract
Objective To explore the clinical value of contrast-enhanced ultrasound(CEUS)in predicting 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 were selected.All patients underwent CEUS within 1 week before treatment and after external radiotherapy.Quantitative parameters were obtained by analyzing the time-intensity curve(TIC),including the time to peak(TP),gradient(Grad),area under the curve(Area)and peak intensity(PI).Meanwhile,the maximum tumor diameters were measured before and after treatment,the tumor regressive rate was calculated.After external radiotherapy,the patients were divided into sensitive group(53 cases)and insensitive group(12 cases)according to the therapeutic effect,and the differences of the above parameters between the two groups were compared.Spearman correlation analysis was used to analyze the correlation between CEUS parameters and tumor regression rate.Binary Logistic regression analysis was used to screen the factors influencing the early therapeutic effect of CCRT in patients with LACC.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficiency.Results The maximum tumor diameter of 65 LACC patients before treatment and after external radiotherapy were(60.7±14.6)mm and(31.2±16.9)mm,respectively.The tumor regression rate was(49.2±23.2)%.Before treatment,the Grad and PI in the sensitive group were lower than those in the insensitive group,and the differences were statistically significant(both P<0.05).After external radiotherapy,Grad,Area and PI in the sensitive group were lower than those before treatment,and TP was higher than that before treatment,and the differences were statistically significant(all P<0.05).Correlation analysis showed that Grad and PI were negatively correlated with tumor regression rate before treatment(r=-0.602,-0.499,both P<0.05).After external radiotherapy,Grad and PI were negatively correlated with tumor regression rate(r=-0.859,-0.913,both P<0.05).Binary Logistic regression analysis showed that Grad and PI before treatment were independent influencing factors for predicting the early efficacy of CCRT in LACC patients.ROC curve analysis showed that the area under the curve of Grad and PI before treatment in predicting the early efficacy of CCRT in LACC patients were 0.802 and 0.894,respectively.Conclusion CEUS has certain clinical value in predicting the early efficacy of CCRT in patients with LACC.
关键词
超声检查/造影剂/局部晚期宫颈癌/同步放化疗/早期疗效Key words
Ultrasonography/Contrast agent/Locally advanced cervical cancer/Concurrent chemoradiotherapy/Early therapeutic effect引用本文复制引用
基金项目
临沂市重点研发计划(2022YX0118)
出版年
2024
NETL
NSTL
维普
万方数据