螺旋CT灌注成像在宫颈癌介入治疗及术后肿瘤活性评价中的应用

Spiral CT perfusion imaging for the evaluation of tumor activity in interventional therapy and after surgery for cervical cancer

目的 探讨螺旋CT灌注成像在宫颈癌介入治疗及术后肿瘤活性评价中的应用价值。方法 选取2017年9月至2021年1月间咸阳市妇幼保健院收治的96例中晚期宫颈癌患者,采用随机数字表法分为介入组和对照组,每组48例。对照组患者采用传统放化疗治疗,介入组患者在对照组基础上采用CT引导125Ⅰ放射性粒子植入治疗,治疗前后采用螺旋CT灌注成像评定肿瘤活性状态。结果 治疗后,介入组患者总有效率为89.6%,高于对照组的58.3%,差异有统计学意义(P<0.05)。治疗后,介入组患者的疼痛情况轻于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者肿瘤单位时间内流经肿瘤的血液容量和肿瘤的血液容积总量均低于治疗前,且介入组均低于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者血清癌胚抗原和细胞角蛋白19片段抗原水平均低于治疗前,且介入组均低于对照组,差异均有统计学意义(均P<0.05)。结论 螺旋CT灌注成像能客观评价宫颈癌患者介入治疗前后的肿瘤活性状态,介入治疗宫颈癌能提高治疗疗效,缓解患者疼痛,抑制血清肿瘤标志物表达。

Objective To explore the value of spiral CT perfusion imaging for the evaluation of tumor activity in interventional therapy and after surgery for cervical cancer.MethodsFrom September 2017 to January 2021,96 patients with advanced cervical cancer were selected at Xianyang Maternal and Child Health Hospital.The patients were divided into an intervention group and a control group with 48 patients in each group using the random number table method.The intervention group received CT-guided radioactive 125 I seed implantation in addition to conventional radiotherapy and chemotherapy and the control group were given conventional radiotherapy and chemotherapy.Spiral CT perfusion imaging was used to assess tumor activity before and after the treatment.Results After the treatment,the overall efficacy rate was 90.0%in the intervention group,which were higher than 58.3% of the control group(P<0.05).After the treatment,the pain grade was milder in the intervention group than in the control group(P<0.05).The blood flow(BF)and blood volume(BV)within the tumor per unit of time were low after the treatment in the two groups compared with those before the treatment and the they were lower in the intervention group were than in the control group(all P<0.05).The serum carcinoembryonic antigen and cytokeratin 19 fragment 21-1 levels in the two groups were low after the treatment compared with those before the treatment and the levels were lower in the intervention group than in the control group(all P<0.05).Conclusion Spiral CT perfusion imaging can objectively evaluate tumor activity status in patients with cervical cancer before and after intervention.Interventional treatment for cervical cancer can improve therapeutic effect,relieve patient pain and inhibit the expression of serum tumor markers.