MRI评估宫颈癌术前临床分期与病理诊断的一致性及预测预后的价值

Consistency and Prognostic Value of MRI Evaluation of Preoperative Clinical Staging and Pathological Diagnosis of Cervical Cancer

目的探究MRI评估宫颈癌患者术前临床分期与病理诊断的一致性,并分析MRI定量参数预测预后的价值。方法选取2020年8月—2022年11月92例宫颈癌为研究对象,均行MRI检查。分析不同临床分期患者术前MRI表现特征,以术后病理诊断结果为“金标准”,评价MRI表现特征评估宫颈癌术前临床分期与病理诊断的一致性。比较治疗后1年不同预后患者术前MRI定量参数[速率常数(K_(ep))、血管细胞外间隙容积比(V_(e))、容积转移常数(K^(trans))],分析MRI定量参数预测预后的价值。结果MRI表现特征评估宫颈癌术前临床分期与病理诊断的一致性Kappa值为0.957(95%CI:0.847,1.045;P<0.001),诊断符合率为95.65%。预后不良患者术前K_(ep)、V_(e)、K^(trans)均高于预后良好患者(P<0.01)。受试者工作特征曲线分析显示,术前K_(ep)、V_(e)、K^(trans)预测宫颈癌患者预后不良的曲线下面积分别为0.806、0.799、0.843。结论MRI表现特征在评估宫颈癌患者术前临床分期方面具有较高可靠性,且术前MRI定量参数K_(ep)、V_(e)、K^(trans)对宫颈癌患者预后情况具有一定预测价值。

Objective To explore the consistency between MRI evaluation of preoperative clinical staging and pathological diagnosis in patients with cervical cancer,and to analyze the value of quantitative MRI parameters in predicting prognosis.Methods Ninety-two patients with cervical cancer from August 2020 to November 2022 were selected as research subjects,and underwent MRI examination.Preoperative MRI features of patients with different clinical stages were analyzed,and the consistency between preoperative clinical stage and pathological diagnosis of cervical cancer was evaluated by using postoperative pathological diagnosis results as the"gold standard".Preoperative MRI quantitative parameters[rate constant(K_(ep)),extravascular volume ratio(V_(e))and volume shift constant(K^(trans))]of patients with different prognoses at 1 year after treatment were compared,and the value of MRI quantitative parameters in predicting prognosis was analyzed.Results The Kappa value of the consistency of MRI features in preoperative clinical staging and pathological diagnosis of cervical cancer was 0.957(95%CI:0.847,1.045;P<0.001),and the diagnostic coincidence rate was 95.65%.K_(ep),V_(e)and K^(trans) in patients with poor prognosis were higher than those in patients with good prognosis(P<0.01).Analysis of receiver operating characteristic(ROC)curve showed that the areas under the ROC curve(AUC)of K_(ep),V_(e)and K^(trans) in predicting poor prognosis of cervical cancer patients before surgery were 0.806,0.799 and 0.843,respectively.Conclusion MRI features have high reliability in evaluating the preoperative clinical staging of patients with cervical cancer,and preoperative quantitative MRI parameters K_(ep),V_(e)and K^(trans) have certain predictive value for the prognosis of patients with cervical cancer.