剪切波弹性成像技术早期诊断宫颈癌的临床应用价值

目的 探讨应用剪切波弹性成像技术早期诊断宫颈癌的临床价值.方法 选取2016年3月至2018年4月经手术病理证实的40例宫颈癌患者(Ca组)及45例宫颈上皮内瘤变患者(CIN组),同期选取45例已婚健康女性为对照组.所有患者均于术前接受经阴道剪切波弹性成像检查,测量并记录宫颈病灶组织的最大弹性模量、平均弹性模量,并与术后病理结果进行对比分析.结果 Ca组宫颈病灶组织的最大弹性模量、平均弹性模量均分别高于CIN组、对照组,差异均有统计学意义(均P<0.05);应用最大弹性模量判定宫颈癌时,最佳临界值31.00KPa,ROC曲线下面积0.912,95%置信区间0.853~0.971,灵敏度0.868,特异度0.809.结论 剪切波弹性成像技术能定量分析宫颈病灶组织的硬度状态,有助于宫颈癌的早期诊断,具有一定临床应用价值.

Objective To investigate the clinical value of shear-wave elastography(SWE)in early diagnosis of cervical cancer. Methods 40 cases of cervical cancer(group Ca)and 45 cases of cervical intraepithelial neoplasia(group CIN),confirmed by postoperative pathology were selected in our hospital from March 2016 to April 2018,and 45 married healthy women as the control group at the same time. All patients received transvaginal SWE before operation. The maximum elastic modulus and the average elastic modulus of cervical lesions were measured and recorded. The results were compared with the postoperative pathological results. Results The maximum elastic modulus and the average elastic modulus of the cervical lesions in the group Ca were higher than those in the group CIN and the control group respectively,the difference were statistically significant(all P<0.05). Using the maximum elastic modulus to determine cervical cancer,the cut-off value =31.00KPa,the area under the curve =0.912,the 95% confidence interval=0.853-0.971,the sensitivity=0.868,specificity=0.809. Conclusion SWE can quantitatively analyze the hardness of cervical lesions,which is helpful for the early diagnosis of cervical cancer,and has certain clinical value.