磁共振弥散加权成像对宫颈癌新辅助化疗后无进展生存期的预测价值

doi:10.11904/j.issn.1002-3070.2014.06.008

实用肿瘤学杂志 ›› 2014, Vol. 28 ›› Issue (6): 519-523.doi: 10.11904/j.issn.1002-3070.2014.06.008

磁共振弥散加权成像对宫颈癌新辅助化疗后无进展生存期的预测价值

朱宏¹, 朱莉¹, 韩世愈¹, 方芳², 于洋¹

1.哈尔滨医科大学附属第四医院妇产科(哈尔滨 150001);
2.哈尔滨医科大学附属第四医院影像科

收稿日期:2014-10-07 出版日期:2014-12-28 发布日期:2015-01-08
通讯作者: 朱莉,E-mail:xyer2000@sina.com.cn
作者简介:朱宏,女,(1979-),硕士,主治医师,从事妇科恶性肿瘤的研究
基金资助:
哈尔滨市科技创新人才项目(2011RFXYS065)

The predictive value of DWI for progression free survival in patients with cervix cancer after neoadjuvant chemotherapy

ZHU Hong¹,ZHU Li¹,HAN Shiyu¹,FANG Fang²,YU Yang¹

1.Department of Gynecology and Obstetrics,The Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,China;
2.Department of Radiology,The Fourth Affiliated Hospital of Harbin Medical University

Received:2014-10-07 Online:2014-12-28 Published:2015-01-08

摘要/Abstract

摘要：

目的探讨磁共振弥散加权成像对新辅助化疗后宫颈癌患者无进展生存期(Progression free survival,PFS)的预测作用。方法回顾性分析经术后病理证实为宫颈癌的患者32例,分析术后病理、治疗前及化疗后常规 MRI 及 DWI 检查结果,用Kaplan-Meier和Cox风险比例回归对所有患者病理结果及MRI资料进行单因素及多因素生存期分析。ROC曲线用于寻找独立预后因素预测疾病进展的临界值。结果 32例患者中10例在随访期出现疾病进展。平均随访时间31.6±6.3个月。单因素分析结果显示FIGO分期、肿瘤最大径线、肌层浸润深度、淋巴结转移及治疗前后ADC值变化(ADC change between before and after neoadjuvant chemotherapy,ΔADC)值与疾病进展有关。多因素分析显示FIGO分期与ΔADC为患者无进展生存期的独立预后因素,ROC曲线获得的临界值分别为2.00和0.31,曲线下面积分别为0.841(敏感度90.0%,特异度68.2%)和0.864(敏感度80.0%,特异度81.8%)。结论在新辅助治疗的宫颈癌患者中,FIGO分期和ΔADC值对无进展生期有一定预测作用。

关键词: 磁共振弥散加权成像, 表观扩散系数, 宫颈癌, 新辅助化疗, 无进展生存期

Abstract:

Objective To evaluate the predictive value of diffusion weighted imaging(DWI)for progression free survival(PFS)in patients with cervix cancer after neoadjuvant chemotherapy(NACT).Methods Thirty two consecutive patients with pathologically confirmed cervical cancer underwent MRI including DWI before and after NACT.Pathologic results and MR images were reviewed.Univariate analysis was applied by Kaplan-Meier method.The Cox proportional hazard model was used to evaluate prognostic variables for multivariate analysis.Receiver operating characteristic(ROC)curves were used to find optimal cutoff values of independent prognostic factors for disease progression.Results Of 32 patients,10 had disease progression during follow-up period.In univariate analysis,FIGO stage,tumor size,the depth of tumor invasion,lymph node metastasis and ADC changes between before and after neoadjuvant chemotherapy(ΔADC)were significantly associated with the disease progression.In multivariate analysis,FIGO stage and ΔADC were the independent prognostic factors for PFS.Optimal cutoff values that determined by ROC curves analyses were FIGO stage Ⅱ and ΔADC 0.31.Area under the ROC curve(AUC)of FIGO stage and ΔADC were 0.841(sensitivity 90.0%,specificity 68.2%)and 0.864(sensitivity 80.0%,specificity 81.8%),respectively.Conclusion In patients with cervix cancer after NACT,FIGO stage andΔADC are significant predictive values for PFS.

Key words: Diffusion weighted imaging(DWI), Apparent diffusion coefficient, Cervical cancer, Neoadjuvant chemotherapy, Progression free survival

中图分类号:

R737.33

朱宏, 朱莉, 韩世愈, 方芳, 于洋. 磁共振弥散加权成像对宫颈癌新辅助化疗后无进展生存期的预测价值[J]. 实用肿瘤学杂志, 2014, 28(6): 519-523.

ZHU Hong,ZHU Li,HAN Shiyu,FANG Fang,YU Yang. The predictive value of DWI for progression free survival in patients with cervix cancer after neoadjuvant chemotherapy[J]. PRACTICAL ONCOLOGY JOURNAL, 2014, 28(6): 519-523.

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磁共振弥散加权成像对宫颈癌新辅助化疗后无进展生存期的预测价值

The predictive value of DWI for progression free survival in patients with cervix cancer after neoadjuvant chemotherapy

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