【作者】 黄建国； 查莉； 曾书娥； 闫福华； 陈春梅； 毛军； 翁高龙；

【Author】 Huang Jian-Guo Za Li Zeng Shu-E et al. Ultrasound Department of Hubei Cancer Hospital, Wuhan 430079 China

【机构】 湖北省肿瘤医院超声科； 湖北省肿瘤医院妇瘤科； 湖北省肿瘤医院病理科；

【摘要】 目的:评价腹腔化疗所致富颈癌血流动力学的变化及其临床意义。方法:宫颈鳞癌者选用顺铂(PDD)100- 20mg／m2、宫颈腺癌者选用顺铂80-100mg／m2、加氟尿嘧啶1．5g／次。将药物溶于1500—2000ml生理盐水中,经腹部穿刺,一次性快速注入腹腔。1-4个疗程。对58例绝经期宫颈癌患者在腹腔化疗前后进行了二维和彩色多普勒血流显像(CDFI)观测。结果:化疗导致富颈癌子宫动脉(A)血流速度降低,病灶内部和周边血流信号减少,其中50％(29／ 58)的病例化疗后在化疗前同等条件下未检测到子宫A的血流速度、81％(47／58)的病例宫颈处血管回声正常。化疗后可检测到子宫A血流速度的2 9例中子宫动脉血流速度≤ 40cm／s占93％(27／29),RI(阻力指数)>0．6占79％(23／ 29)。化疗后子宫A血流速度、RI、肿瘤周边及内部的血流信号较化疗前均有非常显著性(P<0．01)差异变化。化疗后子宫动脉血流速度降低,RI增大,肿瘤周边及内部血流信号减少是疗效良好的表现。相反,化疗后肿瘤周边及内部仍可见血流信号者则需要进一步治疗。结论:CDFI能有效地早期评价宫颈癌腹腔化疗后肿瘤血管对化疗的反应,从而有助于及时调整治疗方案,使其获得更好的疗效。更多还原

【Abstract】 Objective: To evaluate cervical cancer he-modynamic changes after intraperitoneal chemotherapy, and its clinical significance using color Doppler ultrasonography. Methods:Cis-platinum diaminodichl-oride (PDD) 100-120mg/m2 was injected into the patients with cervical squamous cell carcinoma, PDD 80-100mg/ m2 and 5-FU 1.5g per time were injected into the patients with cervical adenocacinoma. 1000-1500ml physiological saline in which the medicine was dissolved was once injected into the abdominal cavity by intraperitoneal puncturing. The course of treatment were 1-4 times. Color Doppler ultrasonography was performed in 58 patients with postmenopausal cervical carcinoma treated with intraperitoneal chemotherapy. Results: Chemotherapy caused the peak-systonic blood flow velocity of uterine artery decreased. The blood signals inside and around the tumor decreased. Uterine artery was not detected by color Doppler ultrasound in 50% (29/58) patients, and the echo from cervical blood vessel was normal in 81%(47/58) patients. After chemotherapy, the uterine artery RI values detected >0.6 was 79% (23/29). The uterine artery peak-systonic blood flow velocity was ≤40cm/s in 93% (27/29) patients. The decrease of the peak-systonic blood flow velocity of uterine artery , the increase of the RI and the reduction of the vascularity around and in the tumor were caused by chemotherapy. All the above parameters, com-pared with the parameters before chemotherapy, were markedly different (P<0.01). The decrease of intratumoral vascularity and reduction of blood flow velocity of uterine artery with mcrease RI during the chemotherapy were associated with better results. However, persistence of excessive vascularity at the end of chemotherapy needed further treatment Conclusion: These results suggested that color Doppler ultrasonography might be useful in the early assessment of vascular therapeutic response to chemotherapy. Modifying the treatment schedules according to early therapeutic response may help achieve better outcome.更多还原