ⅠB1～Ⅱ A1期宫颈鳞癌盆腔淋巴结转移的相关因素分析及3.0T MR-DWI的预测价值

摘要

Objective:To explore the risk factors of pelvic lymph node metastasis in stage Ⅰ B1 ～ Ⅱ A1 cervical squamous cell carrinoma and the predictive value of 3.0T MR-DWI.Methods:71 patients with cervical squamous cell carcinoma of stage Ⅰ B1 ～ Ⅱ A1 confirmed by surgery and pathology in our hospital from January 2015 to December 2016 were retrospectively studied.All the patients were divided into lymph node metastasis group (n=28) or non-lymph node metastasis group (n=43).All the patients underwent both conventional MRI and DWI (b=0,800 and 1000s/mm2) examinations before surgery.The clinical and pathological risk factors and MRI apparent diffusion coefficient (ADC) value of the cervical carcinoma in the two groups were analyzed statistically.Results:Significant statistical difference was found in the depth of stromal invasion (P=0.020),FIGO stage (P=0.045) and vascular invasion (P=0.041) between the two groups (P＜ 0.05),but no statistical difference was showed in the patient's age (P=0.908＞＞0.05) and differentiation degree of tumor cell (P=0.916＞0.05).The mean ADC value of cervical lesions in non-lymph node metastasis group [(0.845±0.104) × 10-3 mm2/s] was lower than that of lymph node metastasis group [(0.901±0.117) × 10-3mm2/s] with significant statistical difference (P＜0.05).Conclusion:FIGO stage,invasion depth and vascular invasion are the risk factors of pelvic lymph node metastasis in stage Ⅰ B1 ～ Ⅱ A1 cervical squamous cell carcinoma.ADC value can be a helpful parameter to predict the risk of pelvic lymph node metastasis to some extent.%目的:探讨Ⅰ B1～Ⅱ A1期宫颈鳞癌盆腔淋巴结转移的相关因素以及3.0T MR-DWI的预测价值.方法:回顾性分析本院2015年1月-2016年12月经术后病理证实的71例Ⅰ B1～Ⅱ A1期宫颈鳞癌患者的病例资料,其中淋巴结转移组28例、非淋巴结转移组43例.患者在手术前均行MR常规扫描和DWI检查(b值取0、800和1000 s/mm2),对两组中相关临床和病理因素以及宫颈癌病灶的表观扩散系数(ADC)值进行统计学分析.结果:两组间FIGO分期(P=0.045)、间质浸润深度(P=0.020)和脉管癌栓(P=0.041)的差异有统计学意义(P＜0.05),而患者年龄(P=0.908)及细胞分化程度(P=0.916)间的差异无统计学意义(P＞0.05).非淋巴结转移组中宫颈癌的ADC均值[(0.845±0.104)×10-3mm2/s]低于淋巴结转移组[(0.901±0.117)×10-3 mm2/s],差异有统计学意义(P＜0.05).结论:FIGO分期、浸润深度及有无脉管癌栓是Ⅰ B1～Ⅱ A1期宫颈鳞癌盆腔淋巴结转移的相关危险因素;宫颈癌病灶的ADC值在一定程度上有助于预测淋巴结转移的风险.