【摘要】 目的 对比分析超声造影参数与糖类抗原125(CA125)、癌胚抗原（CEA）评估宫颈癌新辅助化疗疗效的价值。方法 选取我院行新辅助化疗的宫颈癌患者86例，根据治疗效果分为有效组（69例）和无效组（17例），比较两组化疗前后超声造影参数[上升时间（RT）、峰值强度（PI）、平均通过时间（MTT）、达峰时间（TP）]及CA125、CEA的差异。绘制受试者工作特征（ROC）曲线分析超声造影参数及CA125、CEA评估宫颈癌新辅助化疗疗效的诊断效能。结果 86例宫颈癌患者均行新辅助化疗，总有效率为80.23%。宫颈癌患者化疗后RT、PI、CA125、CEA均低于化疗前，MTT、TP均高于化疗前，差异均有统计学意义（均P<0.05）。化疗前，有效组RT、PI、CA125、CEA均低于无效组，MTT、TP均高于无效组，差异均有统计学意义（均P<0.05）；化疗后，有效组RT、PI、CA125、CEA均低于无效组，MTT、TP均高于无效组，差异均有统计学意义（均P<0.05）。有效组化疗前后各超声造影参数及CA125、CEA比较差异均有统计学意义（均P<0.05）。ROC曲线分析显示，RT、PI、MTT、TP、超声造影综合参数（RT、PI、MTT、TP联合）、CA125、CEA评估宫颈癌新辅助化疗疗效的曲线下面积分别为0.883、0.855、0.813、0.808、0.966、0.746、0.800，超声造影综合参数与CA125、CEA的曲线下面积比较差异均有统计学意义（Z=2.548、2.311,P=0.011、0.021）。结论 超声造影参数评估宫颈癌新辅助化疗疗效的价值较CA125、CEA更佳，能为优化宫颈癌个体治疗方案提供参考。更多还原

【Abstract】 ObjectiveTo compare the value of contrast-enhanced ultrasound parameters,CA125 and carcinoembryonic antigen(CEA)in evaluating the efficacy of neoadjuvant chemotherapy for cervical cancer.MethodsA total of 86 patients with cervical cancer who received neoadjuvant chemotherapy in our hospital were selected and divided into effective group(n=69)and ineffective group(n=17)according to treatment effect.The differences of contrast-enhanced ultrasound parameters[rise time(RT),peak intensity(PI),mean transit time(MTT),time to peak(TP)],CA125 and CEA before and after treatment were compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of contra-enhanced ultrasound parameters and CA125,CEA in evaluating the efficacy of neoadjuvant chemotherapy for cervical cancer.ResultsAll 86 cases of cervical cancer were treated by neoadjuvant chemotherapy,and the total effective rate was80.23%.RT,PI,CA125 and CEA in cervical cancer patients after treatment were lower than those before treatment,while MTT and TP were higher than those before treatment,with statistical significance(all P<0.05).Before treatment,RT,PT,CA125 and CEA in the effective group were lower than those in the ineffective group,while MTT and TP were higher than those in the ineffective group,with statistical significance(all P<0.05).After treatment,RT,PT,CA125 and CEA in the effective group were lower than those in the ineffective group,while MTT and TP were higher than those in the ineffective group,with statistical significance(all P<0.05).There were significant differences in contrast-enhanced ultrasound parameters,CA125 and CEA in the effective group before and after treatment(all P<0.05).ROC curve analysis showed that the the area under the curve of RT,PI,MTT,TP,ultrasound comprehensive parameters(RT,PI,MTT,TP combined),CA125 and CEA in evaluating the efficacy of neoadjuvant chemotherapy for cervical cancer were 0.883,0.855,0.813,0.808,0.966,0.746,0.800,respectively. There were significant differences between the areas under the curve of comprehensive ultrasound parameters and CA125,CEA(Z=2.548,2.311,P=0.011,0.021).ConclusionCompared with CA125 and CEA,contrast-enhanced ultrasound parameters have better value in evaluating the efficacy of neoadjuvant chemotherapy for cervical cancer,and can provide reference for optimizing individual treatment of cervical cancer.更多还原