宫颈癌同步放化疗患者应用超声功能成像评估疗效的价值探析
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摘要
目的探究宫颈癌同步放化疗患者应用超声功能成像评估疗效的价值。方法选取2017年1月-2018年3月我院收治的宫颈癌患者41例,患者均行同步放化疗,采用超声功能成像技术检测治疗前、治疗后1w、2w、治疗结束后功能成像图片及弹性应变比值,分析其与同步放化疗疗效的关系。结果经同步放化疗后,完全缓解者26例(63.41%),部分缓解者15例(36.59%);治疗后宫颈形态明显恢复,病灶减小或消失,宫颈线连续可见;治疗前CR组肿瘤最大长径为(38.64±7.57)mm,治疗后病灶完全消失,PR组为(42.07±8.39)mm,治疗后为(23.94±6.31)mm,明显低于治疗前(P<0.01);治疗后CR组弹性成像图像呈整体绿色,PR组可见病灶中央以绿色为主,部分可见局灶性蓝色区域;随着治疗过程推进,病灶弹性应变比值均呈下降趋势,CR组治疗后1w弹性应变比值开始明显下降,较治疗前显著降低(P<0.05),PR组治疗后2w弹性应变比值出现显著下降趋势,与治疗前比较明显降低(P<0.05);治疗后1w、2w、治疗结束CR组弹性应变比值均低于PR组(P<0.05)。结论超声功能成像可通过早期持续监测弹性应变比值来反映宫颈癌同步放化疗效果,对宫颈癌疗效评估具早期预测价值。
Objective To investigate the value of ultrasound functional imaging in evaluation of the curative effect in patients with cervical cancer undergoing concurrent chemoradiotherapy. Methods A total of 41 patients with cervical cancer who admitted to the hospital from January 2017 to February 2018 were enrolled into the study. All patients were treated with concurrent chemoradiotherapy. Ultrasound functional imagingand the elastic strain ratio was used to detect the lesions before treatment, 1 week and 2 weeks after treatment and at the end of treatment. The curative effect of concurrent chemoradiotherapy was analyzed. Results A total of 26 patients(63.41%) had complete remission(CR) and 15 patients(36.59%) had partial remission(PR) after concurrent chemoradiotherapy. The cervical morphology recovered significantly, the lesions decreased or disappeared, and the cervical line was continuous and visible after treatment. The maximum long diameter in CR group before treatment was(38.64±7.57) mm and lesions disappeared completely after treatment. The maximum long diameter in PR group was significantly decreased after treatment [(42.07±8.39) mm vs(23.94±6.31) mm](P<0.01). The elastic imaging results of CR group were green overall after treatment and in PR group, the central part of the lesion was mainly green, with some focal blue areas. As the treatment progressed, the elastic strain ratio of lesions showed a downward trend. The elastic strain ratio in CR group decreased significantly 1 week after treatment(P<0.05), while the elastic strain ratio in PR group decreased significantly at 2 weeks after treatment(P<0.05). The elastic strain ratios of CR group were lower than those of PR group at 1 week and 2 weeks after treatment and at the end of treatment(P<0.05). Conclusion Ultrasound functional imaging can accurately reflect the effects of concurrent chemoradiotherapy on cervical cancer by early continuous monitoring of elastic strain ratio, and it is of predictive value for evaluating the curative effect on cervical cancer.
Objective To investigate the value of ultrasound functional imaging in evaluation of the curative effect in patients with cervical cancer undergoing concurrent chemoradiotherapy. Methods A total of 41 patients with cervical cancer who admitted to the hospital from January 2017 to February 2018 were enrolled into the study. All patients were treated with concurrent chemoradiotherapy. Ultrasound functional imagingand the elastic strain ratio was used to detect the lesions before treatment, 1 week and 2 weeks after treatment and at the end of treatment. The curative effect of concurrent chemoradiotherapy was analyzed. Results A total of 26 patients(63.41%) had complete remission(CR) and 15 patients(36.59%) had partial remission(PR) after concurrent chemoradiotherapy. The cervical morphology recovered significantly, the lesions decreased or disappeared, and the cervical line was continuous and visible after treatment. The maximum long diameter in CR group before treatment was(38.64±7.57) mm and lesions disappeared completely after treatment. The maximum long diameter in PR group was significantly decreased after treatment [(42.07±8.39) mm vs(23.94±6.31) mm](P<0.01). The elastic imaging results of CR group were green overall after treatment and in PR group, the central part of the lesion was mainly green, with some focal blue areas. As the treatment progressed, the elastic strain ratio of lesions showed a downward trend. The elastic strain ratio in CR group decreased significantly 1 week after treatment(P<0.05), while the elastic strain ratio in PR group decreased significantly at 2 weeks after treatment(P<0.05). The elastic strain ratios of CR group were lower than those of PR group at 1 week and 2 weeks after treatment and at the end of treatment(P<0.05). Conclusion Ultrasound functional imaging can accurately reflect the effects of concurrent chemoradiotherapy on cervical cancer by early continuous monitoring of elastic strain ratio, and it is of predictive value for evaluating the curative effect on cervical cancer.
引文
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[10]黄维,李英,鲁文力,等.宫颈癌同步放化疗时患者临床因素及骨盆剂量体积参数与急性期骨髓抑制的关系[J].第三军医大学学报,2016,38(5):506-510.
[1 1]熊钢,周靖.复方苦参注射液对减轻宫颈癌同步放化疗毒副反应的临床观察[J].现代肿瘤医学,2016,24(23):3787-3790.
[12]Briggs B N,Stender M E,Muljadi P M,et al.A Hertzian contact mechanics based formulation to improve ultrasound elastography assessment of uterine cervical tissuestiffness[J] Journal of Biomechani cs,2015,48(9):1524-1532.
[13]Oturina V,Hammer K,Mollers M, et al.Assessment of cervical elastography strain pattern and its association with preterm birth[J].Journal of Perinatal Medicine,2017,45(8):925-932.
[14]胡丽蓉,冉海涛.超声新技术在宫颈癌诊疗中的应用进展[J].临床超声医学杂志,2014,16(7):472-474.
[15]蒋雪,牛珂,胡晓娟,等.常规腔内超声联合实时剪切波弹性成像评估宫颈癌放化疗疗效[J].中国超声医学杂志,2017,33(7):660-662.
[2]张秋芳,连鹏.浸润性宫颈癌术前CT及MRI诊断的临床价值研究[J].中国CT和MRI杂志,2 01 6, 14(4):1 04-106.
[3]李井平,陈东风,王少春,等.经阴道超高速剪切波弹性成像技术定量评价宫颈癌及癌前病变[J].中国医学影像技术,2 01 6, 32(1 1):1 7 06-1709.
[4]赵亮,刘宏,乌丽娅提·赛都拉.实时剪切波弹性成像与彩色多普勒超声在宫颈癌鉴别诊断中的应用价值[J].中国肿瘤临床与康复,2018,25(1):36-38.
[5]Celiesiute J,Gaurilcikas A,Gedgaudaite M,et al. Transvaginal ultrasound-noninvasive method for the prediction of response to concurrent chemoradiotherapy in cases of cervical cancer[J]. Journal of Vibroengineering,2017,19(3):2180-2187.
[6]Csutak C,Badea R,Bolboaca S D,et al.Multimodal endocavitary ultrasound versus MRI and clinical findings in pre-and posttreatment advanced cervical cancer.Preliminary report[J].MedicalUltrasonography,2016,18(1):75.
[7]Kagabu M,Shoji T,Murakami K, et al.Clinical efficacy of nedaplatinbased concurrent chemoradiotherapy for uterine cervical cancer:a Tohoku Gynecologic Cancer Unit Study[J].International Journal of Clinical Oncology,2016,21(4):1-6.
[8]汪军坚单纯放疗、新辅助化疗及同步放化疗治疗宫颈癌临床近期疗效比较[J].中华肿瘤防治杂志,2016,23(2):246-247.
[9]许涛,景红霞,李林均,等.介入栓塞化疗联合HIFU治疗晚期宫颈癌同步放化疗后局部复发的疗效观察[J].现代妇产科进展,2016,25(2):116-119.
[10]黄维,李英,鲁文力,等.宫颈癌同步放化疗时患者临床因素及骨盆剂量体积参数与急性期骨髓抑制的关系[J].第三军医大学学报,2016,38(5):506-510.
[1 1]熊钢,周靖.复方苦参注射液对减轻宫颈癌同步放化疗毒副反应的临床观察[J].现代肿瘤医学,2016,24(23):3787-3790.
[12]Briggs B N,Stender M E,Muljadi P M,et al.A Hertzian contact mechanics based formulation to improve ultrasound elastography assessment of uterine cervical tissuestiffness[J] Journal of Biomechani cs,2015,48(9):1524-1532.
[13]Oturina V,Hammer K,Mollers M, et al.Assessment of cervical elastography strain pattern and its association with preterm birth[J].Journal of Perinatal Medicine,2017,45(8):925-932.
[14]胡丽蓉,冉海涛.超声新技术在宫颈癌诊疗中的应用进展[J].临床超声医学杂志,2014,16(7):472-474.
[15]蒋雪,牛珂,胡晓娟,等.常规腔内超声联合实时剪切波弹性成像评估宫颈癌放化疗疗效[J].中国超声医学杂志,2017,33(7):660-662.