ADC值预测局部晚期宫颈鳞癌根治性放化疗远期疗效价值初探

Preliminary Study on ADC Value in Predicting Long-term Efficacy of Radical Radiotherapy and Chemotherapy of Locally Advanced Cervical Squamous Cell Carcinoma

目的评估ADC值在治疗早期预测局部晚期宫颈癌患者根治性放化疗疗效的价值。方法根据是否治疗失败将26例行根治性放化疗患者分为治疗成功组与失败组,对比两组治疗前与治疗中肿瘤、宫体ADC值的变化及肿瘤长径的变化。结果治疗成功组宫颈肿瘤治疗前、中ADC值分别为(1.006±0.190)×10^(-3)mm^2/s^3、(2.110±0.322)×10^(-3)mm^2/s^3,宫体治疗前、治疗中ADC值分别为(1.691±0.318)×10^(-3)mm^2/s^3、(1.767±0.312)×10^(-3)mm^2/s^3,肿瘤最长径分别为(5.00±1.53)cm、(1.34±1.49)cm,治疗中、治疗前相比,除宫体ADC值差异无统计学意义(P=0.204),肿瘤ADC值、肿瘤最长径差异有统计学意义(P值均为0.000);宫颈肿瘤治疗失败组治疗前、中ADC值分别为(0.991±0.189)×10^(-3)mm^2/s^3、(1.742±0.244)×10^(-3)mm^2/s^3,宫体治疗前、治疗中ADC值分别为(1.823±0.442)×10^(-3)mm^2/s^3、(1.630±0.372)×10^(-3)mm^2/s^3,肿瘤最长径分别为(5.05±1.06)cm、(4.15±1.29)cm,治疗中、治疗前相比,差异均无统计学意义(P值分别0.405、0.21、0.1);组间对比,治疗中ADC值、肿瘤学最长径差异具有统计学意义(P值分别为0.018、0.000),治疗前ADC、治疗前宫体ADC值、治疗中宫体ADC值、治疗前肿瘤最长径差异无统计学意义(P值分别为0.862、0.419、0.375、0.961)。结论根治性放化疗患者治疗中ADC值较治疗前升高,但治疗失败组与治疗成功组治疗中ADC差异具有统计学意义,故认为治疗中ADC值具有预测局部晚期宫颈癌根治性放化疗远期疗效的能力。

Objective To evaluate the value of ADC in predicting the curative effect of radiotherapy and chemotherapy in patients with locally advanced cervical carcinoma.Methods 26 patients underwent radical radiotherapy and chemotherapy were divided into two groups： successful group and failed group.The changes of ADC value and tumor diameter were compared between the two groups before and after treatment.Results Before and during treatment,the ADC values of tumors in the successful group were（1.006±0.190）×10^（-3）mm^2/s^3、（2.110±0.322）×10^（-3）mm^2/s^3 respectively.The ADC values of corpus uteri were（1.691±0.318）×10^（-3）mm^2/s^3、（1.767±0.312）×10^（-3）mm^2/s^3,respectively.The largest diameter of the tumor were（5.00±1.53） cm、（1.34±1.49） cm,respectively.Before and during treatment,the difference of ADC value of corpus uteri had no statistically significant difference（P=0.204）.But the difference of ADC value and tumor diameter had statistically significant difference（P=0.000）.Before and during treatment,the ADC values of the failed group were（0.991±0.189）×10^（-3）mm^2/s^3,（1.742±0.244）×10^（-3）mm^2/s^3,respectively,and the ADC values of corpus uteri were（1.823±0.442）× 10^（-3）mm^2/s^3、（1.630±0.372）×10^（-3）mm^2/s^3,respectively,the largest diameter of the tumor were（5.05±1.06）cm、（4.15±1.29）cm,respectively.There was no significant difference before and during treatment（P=0.405、0.21、0.1）,and there was significant difference between the two groups about ADC value and tumor diameter（P=0.018,0.000）.ADC value,ADC value of corpus uteribefore treatment,ADC value of corpus uteriduring treatment,the longest diameter of the tumor before treatment had no significant difference（P=0.862,0.419,0.375,0.961）.Conclusion The ADC value of patients treated with radical radiotherapy and chemotherapy is significantly higher than that before treatment.However,there is significant difference between the failure group and the successful treatment group.Therefore,the ADC value can predict long-term efficacy of radical radiotherapy and chemotherapy of locally advanced cervical squamous cell carcinoma.