MRDWI联合CEA及SCC在子宫颈鳞癌同步放化疗疗效评估中的应用研究

摘要

目的 探索MRDWI中ADC值联合SCC、CEA值在宫颈癌同步放化疗疗效监测、预后评估中的应用价值.方法 选取2013-2016年经组织学或细胞学证实的宫颈鳞状细胞癌的初治患者 80例,FIGO分期ⅡB期39例、ⅢA期7例、ⅢB期26例、ⅣA期8例.入组后常规进行MRDWI检查及SCC、CEA检测,根据具体状况采取盆腔外放疗45~50 Gy+同步含铂化疗+后装治疗20~25 Gy,治疗结束后均进行MRDWI、SCC和CEA检查,比较治疗前后ADC值、SCC和CEA检查结果,其中40例于治疗中期予以ADC值、SCC和CEA检查.采用配对t检验或单因素方差分析.结果 80例入组患者经同步放化疗后整体有效率为100%,至治疗结束无患者出现疾病进展且总生存期均在6个月以上.疗后血清中SCC、CEA值较疗前降低(P=0.000、0.000),疗后ADC值较疗前升高(P=0.000).疗后与疗前相比SCC、CEA值越低ADC值越高(P=0.000、0.000),预示宫颈癌同步放化疗疗效越好.结论 MRDWI联合SCC、CEA对宫颈癌同步放化疗疗效监测、预后评估具有较高的可靠性.%Objective To determine the value of the apparent diffusion coefficient (ADC) of magnetic resonance diffusion-weighted imaging (MRDWI) combined with squamous cell carcinoma antigen (SCC) and carcinoembryonic antigen (CEA) in the evaluation of the efficacy and prognosis of concurrent chemoradiotherapy for cervical carcinoma.Methods A total of 80 patients with cervical squamous cell carcinoma confirmed by histology or cytology in our hospital from 2013 to 2016 were included in this study.Of the 80 patients, 39 were FIGO stage ⅡB, 7 were stage ⅢA, 26 were stage ⅢB, and 8 were stage ⅠVA.MRDWI examination and SCC and CEA measurements were first performed for the patients following group assignment, and the patients were then given extrapelvic radiotherapy (45-50 Gy)+platinum-based chemotherapy plus brachytherapy (20-25 Gy) based on their conditions.MRDWI, SCC, and CEA examinations were performed again after treatment to determine the changes in ADC, SCC, and CEA.In addition, ADC, SCC, and CEA were examined in the middle stage of treatment for 40 patients.Data were analyzed using the paired t-test or ANOVA.Results The overall response rate of the 80 patients after concurrent chemoradiotherapy was 100%.No disease progression was identified in any of the patients until the end of treatment, and the overall survival time of the patients was all above 6 months.Serum SCC and CEA were reduced after treatment (P=0.000,0.000), whereas the ADC value was increased after treatment (P=0.000).The increase in ACD following the decreases in SCC and CEA after treatment (P=0.000, 0.000) was indicative of increased efficacy of the concurrent chemotherapy and radiotherapy.Conclusions MRDWI combined with SCC and CEA is highly reliable for the evaluation of efficacy and prognosis of concurrent chemoradiotherapy for cervical cancer.