MRI子宫结合带中断与子宫内膜癌分期的相关性及其临床应用价值

Clinical application value of staging endometrial carcinoma by analyzing the broken uterine junction zone

目的探讨磁共振成像（MRI）子宫结合带（UJZ）变化与子宫内膜癌分期的相关性。方法回顾性总结经临床“诊刮术”确诊为子宫内膜癌患者60例的MRI检查资料，重点分析肿瘤不同发展阶段的UJZ表现并与非癌患者对照组24例（年龄23～55岁）的UJZ表现进行比较。结果①肿瘤组[其中国际妇产科协会（FIGO）分期：早期FIGOⅠ46例，中期FIGOⅡ9例，晚期FIGOⅢ5例）]UJZ中断54例（90％），中断范围长度5～25mm；其中早期40例（86．95％）中仅6例保持连贯性；中、晚期病例均出现较明显的UJZ中断征象（100％）；对照组5例可疑中断（20．83％）；肿瘤组与对照组比较差异有统计学意义，相关系数r=0．717，P〈0．01）；②UJZ的中断变化与肿瘤组各期间呈正相关关系（r=0．528，P〈0．01）。结论UJZ中断改变在肿瘤组与对照组之间的比较，肿瘤组可以见到更为明确的UJZ改变，对照组UJZ水平最低．肿瘤组UZJ水平随分期的增加而提高。

Objective To investigate the interrelationship between the broken uterine junction zone（UJZ） and the stage of endometrial carcinoma. Methods Sixty patients with endometrial carcinoma performed by magnetic resonance imaging（MRI） examination after clinical curettage - pathological diagnosis, mainly analyzed the UJZ disconnection appearance in different stagings of the tumors and compared with contrast group （ non - neoplasma）. Results Broken UJZ due to endometrial carcinoma infiltration myometrium were 54 cases（90.00% ） that broke length from 5 mm to 25 mm retrospectively. Among the 40 cases to be seen, only 6 cases kept its continuity in FICO stage Ⅰ （40/46,86.95%）. All cases of FIGO stage Ⅱ （9 cases） and FICO stage Ⅲ （5 cases） occurred UJZ breakage（ 14/14, 100% ） , and contrast group seen in 5 cases （5/24,20. 83% ）. There were significant differences between both groups （ r =0.717, P 〈0.01 ） ;meanwhile, the degree depth of infiltrated myometrium and various staging of endometrial carcinoma to be closely direct propotion relationship as well （ r = 0. 528, P 〈 0.01 ）. Conclusion It is necessary to be MRI examined during detecting endometrial carcinoma by clinical curettage -pathological diagnosis, it would offer one important sign that is lost the continuity of UJZ as to assess the neoplasma intruded into myometrium especially for early stage.