DWI对宫颈鳞癌同步放化疗后短期预后的预测价值

目的：探讨扩散加权成像（DwI）对宫颈鳞癌同步放化疗短期疗效的预测作用。方法：研究对象选取2009年5月-2010年12月于我院行同步放化疗、并于治疗前在我院行DWl检查的95例宫颈鳞癌患者，测量肿瘤治疗前平均ADC值（ADCmean）及最低ADC值（ADCmin）。根据随访情况（2例失随）将所有患者分为肿瘤无进展组（74例）和进展组（19例），两组间的治疗前ADC值（ADCmean和ADCmin）采用独立样本t检验进行比较；分别以治疗前ADCmean。中位值、ADCmin中位值将所有病例分为ADCmean。较低组与较高组以及ADCmin较低组与较高组，采用Kaplan-Meier曲线及Log—rank检验分析比较不同组间肿瘤1年无进展生存率（PFS）。结果：进展组治疗前ADCmean高于无进展组（1．13±0．14）×10-3mm2／sVS（1．03士0．09）×10-3mm2／s）]，差异有统计学意义（P=0．005），而治疗前ADCmin在两组间差异无统计学意义（P〉0．05）；肿瘤1年PFS在ADCmean较低组（≤1．05×10-3mm2／s）与较高组（〉1．05×10-3mm2／s）之间差异有统计学意义（94％VS66％，P=0．001），而在ADCmin较低组（≤0．82×10-3mm2／s）与较高组（〉0．82×10-3mm2／s）之间差异无统计学意义（87％V873％，P=0．08）。结论：治疗前宫颈鳞癌的ADCmean有助于预测肿瘤同步放化疗的短期预后，能够为临床实施个体化治疗及随诊提供帮助。

DWI predictive value in short-term prognosis of cervical carcinoma with concurrent chemoradiotherapy

Objective：To investigate the apparent diffusion coefficient （ADC） of diffusion-weighted imaging （DWI） in pridicting short-term prognosis of cervical squamous cell carcinoma treated with concurrent chemoradiotherapy （CCRT）. Methods：95 patients of cervical squamous cell carcinoma treatd with CCRT from May 2009 to December 2010 underwent DWI scan before treatment by radical or palliative CCRT were followed up from twelve to thirty months. ADC values, ADC （mean ADC） and ADC~,（minimum ADC）,were calculated. 93 cases were followed up after treatment and 2 cases were lost in contact. The ADC values between groups with different prognoses were compared with independent t test. All cases were divided into two groups according to the median value of ADC,and were compared by using Kaplan-Meier curve and Log-rank test in one-year progression free survival （PFS）. Results： There was higher ADC in tumor progression group than that in progression-free group （ 1.13± 0.14）×10-3mm2/s vs （l. 03± 0.09）×10-3mm2/s, P = 0. 005. How- ever,no statistical difference was conformed in ADCmin between those two groups. Lower ADC group （ADC 41.05 ×10-3mm2/s） had higher progression-free survival （PFS） than the higher ADC group （〉1.05 ×10-3mm2/s） （94% vs 66,P= 0. 001）. However, there was no statistical difference of PFS between the lower ADCmin group （4 0. 82 ×10-3mm2/s） and the higher ADCmin group （〉0. 82×10-3mm2/s） （87% vs 73o/40 ,P=0.08）. Conclusion.. ADC before treatment was useful in predicting short term prognosis of cervical squamous celt carcinoma with CCRT, which could he po- tential to help to implement individualized therapy and post-concurrent chemoradiotherapy follow-up.