CAJ | 학술논문

目的探讨磁共振扩散加权成像(DWI)在预测与评价宫颈癌放化疗疗效中的应用价值.方法收集282例经病理检查证实为宫颈癌的患者,分别在治疗前、治疗结束后行DWI检查,测量肿瘤最大径和表现扩散系数(ADC)值.治疗结束后,依据实体肿瘤疗效评价标准(RECIST)将患者分为缓解组、无效组.根据治疗结束后2年的随访复查情况将患者分为复发组、无复发组.比较两组间的治疗前和治疗结束后ADC值,并分析疗效及复发情况与治疗前ADC值、治疗结束后的ADC升高值之间的相关性.结果缓解组223例,无效组59例.复发组70例,无复发组212例.缓解组治疗前ADC值明显低于无效组(t=3.274,P＜0.05),无复发组治疗前ADC值明显低于复发组(=1.031,P＜0.05).治疗前ADC值低的患者复发率明显低于治疗前ADC值高的患者(x2=5.175,P＜0.05).治疗结束后的疗效及治疗结束后2年的复发情况与治疗前ADC值均呈负相关(r=-0.571、-0.675,P＜0.05),与治疗结束后的ADC升高值均呈正相关(r=0.641、0.547,P＜0.05).缓解组、无复发组治疗结束后ADC值升高明显(t=2.031、4.011,P＜0.05),无效组、复发组ADC值升高不明显.结论治疗前的ADC值有助于预测宫颈癌放化疗疗效,治疗结束后的ADC变化值有助于评价宫颈癌放化疗疗效.
목적 탐토자공진확산가권성상(DWI)재예측여평개궁경암방화료료효중적응용개치.방법 수집282례경병리검사증실위궁경암적환자,분별재치료전、치료결속후행DWI검사,측량종류최대경화표현확산계수(ADC)치.치료결속후,의거실체종류료효평개표준(RECIST)장환자분위완해조、무효조.근거치료결속후2년적수방복사정황장환자분위복발조、무복발조.비교량조간적치료전화치료결속후ADC치,병분석료효급복발정황여치료전ADC치、치료결속후적ADC승고치지간적상관성.결과 완해조223례,무효조59례.복발조70례,무복발조212례.완해조치료전ADC치명현저우무효조(t=3.274,P＜0.05),무복발조치료전ADC치명현저우복발조(=1.031,P＜0.05).치료전ADC치저적환자복발솔명현저우치료전ADC치고적환자(x2=5.175,P＜0.05).치료결속후적료효급치료결속후2년적복발정황여치료전ADC치균정부상관(r=-0.571、-0.675,P＜0.05),여치료결속후적ADC승고치균정정상관(r=0.641、0.547,P＜0.05).완해조、무복발조치료결속후ADC치승고명현(t=2.031、4.011,P＜0.05),무효조、복발조ADC치승고불명현.결론 치료전적ADC치유조우예측궁경암방화료료효,치료결속후적ADC변화치유조우평개궁경암방화료료효.
Objective To investigate the value in application of diffusion-weighted magnetic resonance imaging on predicting and evaluating the efficacy of chemo-radiation therapy in cervical cancer.Methods To tally 282 patients with cervical cancer diagnosed by pathological examination were examined before and after treatments using DWI,while the ADC values and the max diameters were measured.The patients were divided into ease and invalid group on the basis of Response Evaluation Criteria In Solid Tumors (RECIST)after treatments,and divided into recurrence and non recurrence group according to 2-year follow-ups after treatments.The ADC value before and after treatment between the two groups were compared respectively,and correlation test was performed.Results The patients were divided into ease group (223 cases) and invalid group (59 cases),recurrence group (70 cases) and non recurrence group (212 cases).The ADC values of ease group were significantly lower than invalid group before treatments (t =3.274,P ＜ 0.05),which of non recurrence group were significantly lower than recurrence group before treatments(t =1.031,P ＜0.05).The recurrence rates of patients with low ADC values before treatments were significantly lower than the patients with high ADC values before treatments (x2 =5.175,P ＜ 0.05).The efficacy after treatment for 2 months and follow-ups after treatment for 2 years were both negative correlated with the ADC value before treatment (r =-0.571,-0.675,P ＜ 0.05),and positively correlated with the elevated ADC value after treatment(r =0.641,0.547,P ＜ 0.05).The ADC values after treatments of ease group and non recurrence group increased significantly (t =2.031,4.011,P ＜0.05),however,invalid group and the recurrence group increased insignificantly.Conclusions The ADC value before treatment can be used to predict curative effect of chemo-radiation therapy in cervical cancer,while the changes of ADC value after treatment are able to evaluate the efficacy of the treatment.