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目的探讨MR-DWI在宫颈癌新辅助化疗的反应性及其相关组织病理学变化的关系。方法 22例符合手术指征宫颈癌患者分别于新辅助化疗前1d、化疗中2周(第十四天)和4周(第二十八天,术前)行MR-DWI扫描。分别测量记录肿瘤的最大径和多点平均ADC值,比较治疗前后的变化,及其组织病理学变化的相关性并行统计学评价分析。结果肿瘤最大径治疗后2周对比治疗前,无明显变化的22例;治疗后4周对比治疗前,有所缩小的12例,无明显变化的10例(P<0.05);平均ADC值治疗后2周对比治疗前,明显增大的4例,相对增大的12例,变化不大的6例;治疗后四周对比治疗前,明显增大的12例,相对增大的9例,变化不大的1例(P<0.01);术后相关组织病理显示ADC值明显上升的病例镜下组织炎性反应、细胞核异型性、肿瘤细胞死亡程度均显著增大,ADC值相对增大的次之。结论传统手段检测肿瘤最大径治疗后2或4周变化不明显。对照相关组织病理学变化,DWI能更早地监测到肿瘤治疗的反应性。DWI可作为肿瘤治疗的早期检测指标,并可预测治疗效果。
Objective To investigate the relationship between MR-DWI and neoadjuvant chemotherapy in cervical cancer and its related histopathological changes. Methods Twenty-two patients with cervical cancer who underwent surgical indications underwent MR-DWI scanning 1 day before neoadjuvant chemotherapy, 2 weeks (14th day) and 4 weeks (28th day, preoperative) in chemotherapy. The maximum diameter and multi-point average ADC value of the tumor were measured and recorded. The changes before and after treatment were compared with those of histopathological changes. Statistical analysis was performed. Results There was no significant change in the maximum diameter of the tumors between the two weeks after treatment and two weeks after the treatment. There were 12 cases with no significant change in the 4 weeks after the treatment (P <0.05), and the average ADC value After 2 weeks of treatment, there were 4 cases of obvious increase, 12 cases of relative increase and 6 cases of little change. After 12 weeks of treatment, 12 cases were significantly increased, 9 cases were relatively increased (P <0.01). The postoperative histopathology showed a significant increase in ADC value of microscopic inflammatory reaction, nuclear atypia, the degree of tumor cell death were significantly increased, ADC value of the relative increase in the second It Conclusion The maximum diameter of the tumor detected by traditional means did not change obviously 2 or 4 weeks after treatment. DWI was able to monitor the response of tumor therapy earlier than the corresponding histopathological changes. DWI can be used as an early detection of cancer treatment indicators, and predict the treatment effect.