血管化指数VI在预测宫颈鳞癌新辅助化疗敏感性中的应用

摘要

目的：经阴道三维彩色血管能量成像（3D-CPA）检测宫颈鳞癌的血流参数及体积，探讨其在宫颈鳞癌新辅助化疗疗效评价中的应用价值。方法：对32例Ⅰb2、Ⅱa2期术前行新辅助化疗的宫颈鳞癌患者，在化疗前后进行实时3D-CPA扫查，测量肿瘤局部血流相关数据（血管化指数 VI、血流指数 FI、血管血流指数VFI）及肿瘤体积。结果：宫颈鳞癌患者在癌新辅助化疗前，有效组VI值（35.136±8.433）％与无效组VI值（48.270±14.547）％比较，差异有统计学意义（ P＜0.05），同时新辅助化疗前的VI值与癌组织浸润深度及淋巴结转移呈正相关。有效组肿瘤局部血供参数表达水平在新辅助化疗后明显下降，前后差异有统计学意义（P＜0.00）。结论：3D-CPA测 VI值与肿瘤体积，是预测宫颈癌患者新辅助化疗疗效的有效方法。%Objective:To evaluate the application value of the three-dimensional power Doppler sonography fore-casting the effect of neoadjuvant chemotherapy on cervical squamous cell carcinoma. Methods:All 32 patients in FI-GO stageⅠb2 andⅡa2 of the cervical cancer were given TP( TAX﹢DDP)and were studied by the three-dimension-al power Doppler sonography,and relevant data( cervical tumor volume ,vascularization index VI ,flow index FI , vascularization -flow index VFI)were measured. Results:Before NACT,in those responsive to NACT VI(35. 136 ± 8. 433)% decreased significantly than poor response to NACT(48. 270 ± 14. 547)%,and there was a significant difference in the two groups(P<0. 05). Meanwhile,there was a significant correlation between the value of VI and the depth of invasion and lymph node metastasis of cervix cancer patiernts(P<0. 05). After NACT,the blood supply relevant data( VI,FI,VFI)and cervical tumor volume decreased significantly than before treatment in those respon-sive to NACT. However,there was no significant difference in patients with poor response to NACT. Conclusion:Three-dimensional power Doppler sonography,especially the VI can objectively reflect the state of blood supply of the cer-vical cancer,is useful to forecast the effect of neoadjuvant chemotherapy to cervical carcinoma.