摘要
目的分析CT血管造影与ⅠB2~ⅢA期宫颈癌患者新辅助化疗(NACT)耐药性的关系。方法选取2017年3月至2019年3月在本院接受新辅助化疗的ⅠB2~ⅢA期宫颈癌患者62例作为研究对象,分别在治疗前、治疗结束后三周行CT血管造影检查,观察化疗前后CT影像学特点,比较近期疗效,分析CT血管造影参数与NACT耐药性的相关性。结果所有患者采用新辅助化疗后1周再次行CT血管造影,其中CR 8例,PR 38例,SD 11例,PD 5例,总有效率74.19%,无效率25.81%,即对化疗敏感46例,耐药16例;耐药组患者的CT影像学特征为肿瘤的局部生长呈内生溃疡型、盆壁粘连严重,阴道盆壁间隙消失,宫旁组织出现高密度影;敏感组和耐药组治疗前的血流量(BF)、血容量(BV)、表面通透性(PS)、平均通过时间(MTT)比较差异无统计学意义(P>0.05),治疗后两组患者的BF、BV、PS均较治疗前显著降低,MTT较治疗前显著增高(P<0.05),且敏感组显著优于耐药组,两组比较差异具有统计学意义(P<0.05);根据Pearson相关性分析结果显示,血流参数BF、BV与耐药性呈负相关(P<0.05)。结论采用NACT化疗治疗中晚期宫颈癌患者近期疗效较好,NACT治疗方案对肿瘤的血管形态及血管影像学参数的影响直接关系到化疗的敏感性,CT血管造影对宫颈癌患者NACT的耐药性具有重要的预测价值。
Objective To analyze the relationship between CT angiography and neoadjuvant chemotherapy(NACT)resistance in patients with stage IB2~ⅢA cervical cancer.Methods Sixty-two patients with stageⅠB2-ⅢA cervical cancer underwent neoadjuvant chemotherapy in the hospital between March 2017 and March 2019 were selected as the study subjects.CT angiography was performed before treatment and at three week after treatment.CT imaging characteristics were observed before and after chemotherapy,and the short-term curative effect was compared.The correlation between CT angiography parameters and NACT resistance was analyzed.Results All patients completed CT angiography at one week after NACT,including 8 cases with CR,38 cases with PR,11 cases with SD and 5 cases with PD.The total effective rate and ineffective rate were 74.19%and 25.81%,respectively.There were 46 cases sensitive to chemotherapy and 16 cases with drug resistance.The CT imaging characteristics of patients in the drug-resistant group included local growth of the tumor showing endogenous ulcer type,severe pelvic wall adhesions,disappearance of the gap between the vagina and the pelvic wall and high-density shadows in the uterine tissues.There was no significant difference in blood flow(BF),blood volume(BV),surface permeability(PS)or mean transit time(MTT)between the sensitive group and the drug-resistant group before treatment(P>0.05).After treatment,BF,BV and PS in both groups were significantly decreased,while MTT was significantly prolonged(P<0.05).Besides,the above indexes in the sensitive group were significantly better than those in the drugresistant group(P<0.05).Pearson correlation analysis showed that blood flow parameters BF and BV were negatively correlated with drug resistance(P<0.05).Conclusion NACT is effective in the treatment of patients with advanced cervical cancer.The effect of NACT on tumor vascular morphology and angiographic parameters is directly related to the sensitivity to chemotherapy.CT angiography is of great value in predicting the
作者
邵俊伟
潘学兵
何宇
SHAO Jun-wei;PAN Xue-bing;HE Yu(Department of Oncology,Dongguan People's Hospital,Dongguan 523000,Guangdong Province,China)
出处
《中国CT和MRI杂志》
2022年第4期132-134,共3页
Chinese Journal of CT and MRI
关键词
CT血管造影
宫颈癌
化疗
耐药性
CT Angiography
Cervical Cancer
Chemotherapy
Drug Resistance
