【摘要】 目的 评估CT灌注成像(CTP)在头颈部鳞癌临床分期的诊断价值,探讨灌注参数与细胞角蛋白19片段抗原21-1(Cyfra21-1)的临床相关性。方法 收集63例经病理证实的头颈部鳞癌患者,按国际临床分期标准分为3组(Ⅰ期,Ⅱ期,Ⅲ～Ⅳ期),均于术前行CTP检查,测量灌注参数血流量(BF)、血容量(BV)、平均通过时间(MTT)、达峰时间(TTP),并记录血清Cyfra21-1的结果,比较上述参数与鳞癌不同临床分期的相关性。结果 Ⅰ期、Ⅱ期鳞癌的Cyfra21-1值差异无统计学意义(Z=1.439,P=0.162);Ⅰ期与Ⅲ～Ⅳ期的Cyfra21-1值差异有统计学意义(Z=3.356,P=0.000);Ⅱ期与Ⅲ～Ⅳ期的Cyfra21-1值差异有统计学意义(Z=4.959,P=0.000)。Ⅰ期与Ⅱ期、Ⅲ～Ⅳ期的BF、BV值的差异有统计学意义(P<0.05);Ⅲ～Ⅳ期的MTT、TTP值与Ⅰ期、Ⅱ期比较有统计学意义(P<0.05)。Ⅱ期与Ⅲ～Ⅳ期的BF、BV值的差异无统计学意义(P>0.05);Ⅰ期与Ⅱ期的MTT、TTP值的差异无统计学意义(P>0.05)。不同分期的Cyfra21-1与灌注参数的相关性分析,r值分别为0.76,0.76,-0.82,-0.82,P值均<0.05。结论CT灌注成像结合血清Cyfra21-1在头颈部鳞癌的临床分期方面有一定的参考价值。更多还原

【Abstract】 Objective To estimate the value of computed tomography perfusion for clinical stage and approach the correlation of perfusion parameters and Cyfra21-1.Methods 63 patients with head and neck squamous carcinoma were confirmed by pathology and follow up underwent CT perfusion,which were divided into three groups by international clinical staging criteria(stage Ⅰ,stage Ⅱ and stageⅢ-Ⅳ).BF,BV,MTT,TTP and Cyfra21-1 were recorded and compared with correlation in different clinical staging.Results There was no significant difference of Cyfra21-1 between stage Ⅰ and stage Ⅱ(Z=1.439,P=0.162).There was significant difference of Cyfra21-1 between stage Ⅰ and stageⅢ-Ⅳ(Z=3.356,P=0.000),stage Ⅱ and stage Ⅲ-Ⅳ(Z=4.959,P=0.000).There was significant difference of BF and BV between stage Ⅰ and stage Ⅱ,stage Ⅰ and stageⅢ-Ⅳ(P<0.05),of MTT and TTP between stage Ⅰ and stage Ⅲ-Ⅳ,stage Ⅱ and stage Ⅲ-Ⅳ(P<0.05).There was no significant difference of BF and BV between stage Ⅱ and stage Ⅱl-Ⅳ(P>0.05),of MTT and TTP between stage Ⅰ and stage Ⅱ(P>0.05).Cyfra21-1 and perfusion parameters in all groups have relationship(r=0.76,0.76,-0.82,-0.82,P<0.05).Conclusion The statistically significant of positive correlation between Cyfra21-1 and perfusion parameters in head and neck squamous carcinoma suggests that CT perfusion could play a complementary role in clinical assessment.更多还原