术前介入治疗对ⅠB~ ⅡB 期宫颈癌治疗效果的分析.docVIP

术前介入治疗对ⅠB～ⅡB 期宫颈癌治疗效果的分析 蔡名金1、麦伟文2、生秀杰1、何婉玲1、原志光1 （1 广州医学院第三附属医院放射科510150 2 广州医学院第三附属医院妇产科 510150） [摘要] 目的 通过对宫颈癌治疗前后MRI表现的分析，探讨术前介入治疗（动脉灌注化疗栓塞）对ⅠB～ⅡB期宫颈癌患者的近期与远期疗效的影响。方法 将我院2000年1月—2007年11月期间收治的68例ⅠB～ⅡB宫颈癌患者随机分为观察组和对照组。观察组33例，术前介入治疗联合手术治疗，对照组35例，采用单纯手术治疗。治疗前后行MIR检查，观察MIR图像上治疗前后肿瘤大小及信号变化，比较两组的术后的生存率。结果 MRI示观察组总有效率为88.68%；T2WI 信号变化 观察组26例（78.79%）信号消失；T1WI 增强扫描肿瘤强化表现 观察组 25（75.76%)例肿瘤不强化或轻微强化；淋巴结转移变化 观察组盆腔内淋巴结肿大11例（33.33%）。两组比较对照组与观察组3年生存率分别为82.89%和84.85%（P0.05），而对照组与观察组5年生存率分别为51.43%和75.76%（P0.05）。结论 术前介入治疗能为宫颈癌患者进行根治手术创造条件，降低术后复发，改善预后，是一种疗效显著的治疗方法。MRI成像对宫颈癌介入治疗疗效评估具有重要意义。 [关键词] 宫颈癌；介入治疗；磁共振成像；疗效；预后 The Effects of Preoperative Interventional Therapy on StageⅠB-ⅡB Cervical Carcinoma [Abstract] Objective: Through presenting the findings of cervical carcinoma before, during and after therapy by magnetic resonance (MRI) imaging, To investigate the short-term and long-term clinical efficacy of preoperative interventional therapy (intraarterial chemoembolization) on stageⅠB-ⅡB cervical cancer. Methods: From January 2000 to November 2007, 68 patients with stageⅠB-ⅡB cervical cancer were enrolled and randomly divided into the study group and the control group. Patients in the study group (n=33) were treated with preoperative interventional therapy and surgical therapy. Patients in the control group (n=35) received surgical therapy. The changes of carcinoma lesion in size and signal were evaluated on MR images. And the postoperative survival rates were compared between the two groups. Results：The overall effective rate was 88.68%，the tumor signals disappeared in 26（78.79%） tumors on T2WI，slight or no enhancement was observed in 25 （75.76%)patients，lymphadenectasis of pelvic cavity was observed in 11（33.33%） patients .The 3-year survival rate was 82.89% in the control group and84.85% in the study group(P0.05). The 5-year survival rate was 51.43% in the control group and75.76% in the study group (P0.05).Conclusion: For patients with IB2-IIB stage cervical cancer, preoperative