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使用多层螺旋CT灌注测定的血管通透性可预测晚期宫颈鳞状细胞癌患者对放化疗的反应。

Vascular permeability determined using multi-slice spiral CT perfusion can predict response to chemoradiotherapy in patients with advanced cervical squamous cell carcinoma
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作者信息

Liu Jie, Fan Hua, Qiu Guang-Ping

出版信息

Int J Clin Pharmacol Ther. 2017 Jul;55(7):619-626. doi: 10.5414/CP202847.

Abstract

AIM

This study aims to use multi-slice spiral computed tomography (CT) perfusion to investigate the predictive value of vascular permeability in determining the response of patients with advanced cervical squamous-cell carcinoma (CSCC) to chemoradiotherapy treatment.

METHODS

196 patients with advanced CSCC were recruited. Multi-slice spiral CT perfusion was performed before chemoradiotherapy, and perfusion parameters, such as blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS), were obtained. After treatment, patients were divided into a sensitive group and a resistant group. Receiver operating characteristic (ROC) analysis was performed to evaluate the predictive value of the perfusion parameters. The association of the perfusion parameters with the response of CSCC to chemoradiotherapy was analyzed using logistic regression analysis.

RESULTS

Lesion size and treatment duration were remarkably different between the sensitive (n = 101) and resistant groups (n = 95) (both p < 0.05). Before chemoradiotherapy, the sensitive group had a significantly higher BV and PS than the resistant group (both p < 0.05). The logistic regression analysis showed that lesion size, BV, and PS are associated with the response of CSCC to chemoradiotherapy (all p < 0.05). The sensitivity and the specificity of BV and PS were 65.3% and 83.2% and 75.2% and 72.6%, respectively.

CONCLUSION: BV and PS values determined using CT perfusion correlate with and predict the response to chemoradiotherapy in the treatment of advanced CSCC. Patients with smaller lesions require shorter periods of treatment.
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摘要

目的

本研究旨在利用多层螺旋计算机断层扫描(CT)灌注技术,探讨血管通透性在确定晚期宫颈鳞状细胞癌(CSCC)患者对放化疗反应中的预测价值。

方法

招募196例晚期CSCC患者。在放化疗前进行多层螺旋CT灌注检查,获取血流(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS)等灌注参数。治疗后,将患者分为敏感组和耐药组。采用受试者操作特征(ROC)分析评估灌注参数的预测价值。使用逻辑回归分析灌注参数与CSCC对放化疗反应之间的关联。

结果

敏感组(n = 101)和耐药组(n = 95)之间的病变大小和治疗持续时间存在显著差异(均p < 0.05)。放化疗前,敏感组的BV和PS显著高于耐药组(均p < 0.05)。逻辑回归分析显示,病变大小、BV和PS与CSCC对放化疗的反应相关(均p < 0.05)。BV和PS的敏感性和特异性分别为65.3%和83.2%以及75.2%和72.6%。

结论

CT灌注测定的BV和PS值与晚期CSCC治疗中放化疗的反应相关,并可预测该反应。病变较小的患者所需治疗时间较短。

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