Sofic Amela, Husic-Selimovic Azra, Beslic Nermina, Rasic Azra, Begic Dzenana, Tomic-Cica Anja, Imsirevic Nejira
Clinic of Radiology, Clinical center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Institute of Gastroenterohepatology, Clinical center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Acta Inform Med. 2017 Mar;25(1):39-43. doi: 10.5455/aim.2017.25.39-43.
The goal of this study was the determination of the effects in treatment of early stage (<IIB) and locally advanced stages (≥IIB) of uterine cervical carcinoma by using MRI.
The study was a prospective, comparative, analytical, and observational and included 74 patients with cervical cancer (PH confirmed). All 74 patients have initially gone through the pre-therapeutic MRI to determine the tumour FIGO stage. At a renewal of the initial MRI findings, patients were divided into two study groups: group A and group B. Group A consisted from 39 patients with early-stage cervical carcinoma (<IIB) and group B comprised from 35 patients with locally advanced stage (≥IIB). Postterapeutic MRI control, were perfomed in both group (A and B). Further MRI examinations were set for the patients from both groups.
An analysis of treatment outcomes in group A showed that most patients had no local recurrence or residuum disease in 89.7%, while local recurrence was observed in only 10.3% cases. An analysis of treatment outcomes in group B showed that most patients had complete regression after local chemoradiotherapy in 68.8%, while 25.7% of patients had local progression of the disease, while the 5.7% cases recorded partial local tumour regression(p<0.05). It has been shown that a complete local regression was more frequent in the case of squamous cell carcinoma in 74.2% vs 25% in adenocarcinoma cases. Also local and partial regression was observed more frequently in the case of squamous cell carcinoma in 6.5% compared to 0% in adenocarcinoma, while progression was more common in adenocarcinoma at 75% compared to 19.4% for squamous cell (p<0.05). MRI results showed positive outcome of treatment group A and B in our study, showed a statistically significant difference in favour of group A (89.7%) compared to group B 68.8% (p<0.05).
The results obtained from our studies show that early stage cervical cancer (<IIB) shows a better outcome in treatment of advanced stages (≥IIB). In the treatment of advanced stages (≥IIB), concomitant radio chemotherapy shows significant results in terms of complete tumour regression, especially in squamous cell type of cervical cancer.
本研究的目的是确定使用MRI治疗早期（<IIB期）和局部晚期（≥IIB期）子宫颈癌的效果。
本研究为前瞻性、对比性、分析性和观察性研究，纳入74例宫颈癌患者（经病理证实）。所有74例患者均首先进行了治疗前MRI检查以确定肿瘤的国际妇产科联盟（FIGO）分期。根据初次MRI检查结果，将患者分为两个研究组：A组和B组。A组由39例早期宫颈癌（<IIB期）患者组成，B组由35例局部晚期（≥IIB期）患者组成。两组（A组和B组）均进行了治疗后MRI复查。对两组患者均安排了进一步的MRI检查。
A组治疗结果分析显示，大多数患者（89.7%）无局部复发或残留疾病，仅10.3%的病例观察到局部复发。B组治疗结果分析显示，大多数患者（68.8%）在局部放化疗后完全缓解，25.7%的患者疾病局部进展，5.7%的病例记录为局部肿瘤部分消退（p<0.05）。结果表明，鳞状细胞癌患者完全局部缓解更为常见，占74.2%，腺癌患者为25%。鳞状细胞癌患者局部和部分消退也更为常见，占6.5%，腺癌患者为0%，而腺癌患者疾病进展更为常见，占75%，鳞状细胞癌患者为19.4%（p<0.05）。MRI结果显示本研究中A组和B组治疗效果良好，与B组的68.8%相比，A组（89.7%）有统计学显著差异（p<0.05）。
我们的研究结果表明，早期宫颈癌（<IIB期）的治疗效果优于晚期（≥IIB期）。在晚期（≥IIB期）宫颈癌的治疗中，同步放化疗在肿瘤完全消退方面显示出显著效果，尤其是鳞状细胞型宫颈癌。
