RTSWE对宫颈癌及癌前病变的筛查价值

The diagnostic value for cervical cancer and precancerous lesions by RTSWE

目的探讨实时剪切波弹性成像(RTSWE)对宫颈癌前病变及宫颈癌的筛查价值。方法回顾性选取2021年10月至2022年3月期间在长春市妇产医院检测出宫颈病变且接受实时剪切波弹性成像检查的40例已婚女性患者,通过组织病理结果,将其分为宫颈上皮内瘤变(n=25)和宫颈癌组(n=15),并取同期在医院进行体检的健康者25例作为对照组,比较3组宫颈弹性成像图像、弹性模量最大值及平均值,并绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),综合评定RTSWE的诊断价值。结果宫颈上皮内瘤变组和宫颈癌组的平均弹性成像硬度评分相较于对照组明显升高(P<0.05);相较于对照组,宫颈癌组的弹性模量最大值及平均值也明显升高(P<0.05),宫颈上皮内瘤变组与对照组间差异无统计学意义(P>0.05);宫颈癌组RTSWE-E_(max)和E_(mean)的AUC面积分别为0.91,0.82,差异具有统计学意义(P<0.05)。结论RTSWE对宫颈癌的筛查提供新思路,可以简单、快速地对宫颈癌的良恶性做出初步评定,具有良好的临床应用价值,而对于癌前病变的筛查准确性较低。

Objective To investigate the screening value of real-time shear wave elastography(RTSWE)for cervical precancerous lesions and cervical cancer,and to explore its clinical significance.Methods From October 2021 to March 2022,40 married female patients with cervical lesions detected in changchun maternity hospital who received real-time shear wave elastography were retrospectively selected.According to the histopathological results,they were divided into cervical epithelium Endomatosis(n=25)and cervical cancer group(n=15),and 25 healthy people who underwent physical examination in our hospital during the same period were selected as the control group,and the cervical elastography images,maximum elastic modulus and average values of the three groups were compared.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to comprehensively assess the diagnostic value of RTSWE.Results Compared with the control group,the average elastography hardness scores of the cervical intraepithelial neoplasia group and cervical cancer group were significantly higher(P<0.05);compared with the control group,the maximum and average values of elastic modulus of the cervical cancer group It was also significantly higher(P<0.05),and there was no significant difference between the cervical intraepithelial neoplasia group and the control group(P>0.05);the AUC areas of RTSWE-E_(max)and E_(mean)in the cervical cancer group were 0.91 and 0.82,respectively.Significant difference(P<0.05).Conclusion RTSWE provides a new idea for cervical cancer screening,which can make a simple and rapid preliminary assessment of benign and malignant cervical cancer,which has good clinical application value,but the screening accuracy of precancerous lesions is low.