Cheng Jinlong, Hou Yan, Li Junnan, Wang Wenjie, Xu Ye, Yang Chunyan, Ma Libing, Dhillon Harman S, Openkova Margarita S, Fan Xin, Li Zhenzi, Li Kang, Lou Ge
*Department of Gynecology Oncology, The Affiliated Tumor Hospital of Harbin Medical University; †Department of Epidemiology and Biostatistics, School of Public Health, Harbin Medical University; ‡Key Laboratory of Cardiovascular Medicine Research (Harbin Medical University), Ministry of Education; §Harbin Medical University; and ∥Basic Medicine School, Heilongjiang University of Chinese Medicine, Harbin, People's Republic of China.
Int J Gynecol Cancer. 2017 Sep;27(7):1472-1479. doi: 10.1097/IGC.0000000000001038.
To compare the agreement between magnetic resonance imaging (MRI) results and postsurgical pathologic findings for tumor size evaluation in cervical cancer patients before and after neoadjuvant chemotherapy (NACT) treatment.
The study analyzed the agreement between pretreatment MRI results and postsurgical pathologic findings about the tumor size in 100 cervical cancer patients without NACT and 397 cervical cancer patients with NACT, respectively.
In general, the agreement between pretreatment MRI results and postsurgical pathologic findings of tumor size was 0.855 (95% confidence interval [CI], 0.763-0.909) in cervical cancer patients without NACT, whereas the agreement between posttreatment MRI results and postsurgical pathologic findings was 0.503 (95% CI, 0.421-0.576). Only 62.72% (249/397) of patients who underwent NACT treatment have the same chemotherapy response evaluation results; the κ coefficient was 0.384(95% CI, 0.310-0.457) between posttreatment MRI and postsurgical pathologic findings. We still found International Federation of Gynecology and Obstetrics stage is associated with the chemotherapy response evaluation.
Our data suggest that pretreatment MRI can be a surrogate indicator for postsurgical pathologic findings. However, posttreatment MRI could not be a surrogate indicator for postsurgical pathologic findings. The chemotherapy response evaluation based on only MRI is not so reliable. More indicators should be developed for chemotherapy response evaluation.
比较新辅助化疗（NACT）治疗前后宫颈癌患者磁共振成像（MRI）结果与术后病理结果在肿瘤大小评估方面的一致性。
该研究分别分析了100例未接受NACT的宫颈癌患者和397例接受NACT的宫颈癌患者治疗前MRI结果与术后病理结果在肿瘤大小方面的一致性。
总体而言，未接受NACT的宫颈癌患者治疗前MRI结果与术后病理结果在肿瘤大小方面的一致性为0.855（95%置信区间[CI]，0.763 - 0.909），而接受治疗后MRI结果与术后病理结果的一致性为0.503（95%CI，0.421 - 0.576）。接受NACT治疗的患者中只有62.72%（249/397）的化疗反应评估结果相同；治疗后MRI与术后病理结果之间的κ系数为0.384（95%CI，0.310 - 0.457）。我们仍然发现国际妇产科联盟分期与化疗反应评估相关。
我们的数据表明，治疗前MRI可作为术后病理结果的替代指标。然而，治疗后MRI不能作为术后病理结果的替代指标。仅基于MRI的化疗反应评估不太可靠。应开发更多指标用于化疗反应评估。
