目的 探究动态增强磁共振成像(DCE-MRI)定量参数对宫颈癌患者复发危险度及3 年生存率的影响.方法 将2019 年4 月—2022 年4 月收治的宫颈癌100 例作为观察组,另选取同期体检宫颈正常女性作为对照组,均行DCE-MRI检查,比较 2 组DCE-MRI定量参数,比较肿瘤复发与未复发患者临床特征及DCE-MRI定量参数,评价DCE-MRI定量参数对宫颈癌患者肿瘤复发的预测价值,比较不同水平DCE-MRI定量参数患者 3 年生存情况.结果 观察组容积运转常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积比(Ve)高于对照组(P＜0.01);肿瘤复发患者Ktrans、Kep、Ve 高于未复发患者(P＜0.01).Ktrans、Kep、Ve 联合预测宫颈癌患者肿瘤复发的曲线下面积(0.932)最大.宫颈癌患者Ktrans、Kep、Ve 为高水平时,复发风险是低水平患者的2.250、2.432、1.995 倍(P＜0.05).Ktrans、Kep、Ve高水平宫颈癌患者3 年内生存率分别低于Ktrans、Kep、Ve 低水平患者(P＜0.05).结论 DCE-MRI定量参数与宫颈癌患者肿瘤复发危险度及3 年生存率有关.

目的 探讨miR-124-3p和SEPT9在宫颈癌中的表达并分析二者与宫颈癌患者临床表现的相关性.方法 收集2016年5月至2019年5月在石家庄市妇幼保健院接受手术切除的患者中获得94份宫颈癌组织样本和匹配的癌旁正常组织样本.qRT-PCR用于检测miR-124-3p表达;免疫组织化学用于分析SEPT9的阳性表达;比较宫颈癌中miR-124-3p和SEPT9表达与临床特征表现的相关性;Strabase网站预测miR-124-3p和SEPT9靶向关系,Spearman等级分析宫颈癌中miR-124-3p和SEPT9表达的相关性;Kaplan-Meier生存分析和COX回归分析探讨miR-124-3p和SEPT9表达与宫颈癌患者预后的关系.结果 与癌旁正常组织比较,宫颈癌组织中miR-124-3p相对表达水平水平降低,SEPT9阳性率升高(P＜0.05).宫颈癌组织中miR-124-3p、SEPT9表达均与肿瘤大小、FIGO分期和淋巴结转移相关(P＜0.05).miR-124-3p和SEPT9存在互补作用位点,且在宫颈癌组织中呈负相关(P＜0.05).宫颈癌组织中miR-124-3p低表达患者3年总生存率(29.79％)低于miR-124-3p高表达患者3年总生存率(59.57％),SEPT9阳性表达患者3年总生存率(56.25％)低于SEPT9阴性表达患者3年总生存率(20.00％)(P＜0.05).SEPT9表达、肿瘤大小、FIGO分期、淋巴结转移是宫颈癌预后的独立危险因素(P＜0.05).结论 宫颈癌组织中miR-124-3p表达下调,是宫颈癌预后的独立保护因素;SEPT9表达上调,是宫颈癌预后的独立危险因素,二者呈负相关.

目的 探讨动态对比增强MRI(DCE-MRI)评估宫颈癌临床分期价值及其定量参数对生存情况影响.方法 选取2020年8月—2022年11月收治的宫颈癌106例,观察比较其不同临床分期DCE-MRI表现、定量参数;探讨DCE-MRI评估宫颈癌临床分期价值,并分析不同DCE-MRI容积运转常数(KTrans)宫颈癌患者3年生存情况.结果 宫颈癌患者Ⅰ期表现为T2 WI矢状位宫颈内膜不均匀信号,病灶边界欠清晰,宫颈内膜不连续,未达宫体;Ⅱ期表现为T1 WI矢状位见肿瘤病灶强化不均匀,肿瘤信号超出宫颈,延伸至阴道上2/3,宫颈周围信号正常,无宫旁浸润;Ⅲ期主要表现为T2 WI矢状位呈不均匀略高信号,侵及阴道下1/3;Ⅳ期主要表现为T2 WI矢状位见肿瘤病灶侵袭子宫、阴道,且累及子宫肌层及膀胱.随着宫颈癌患者临床分期增加DCE-MRI KTrans呈逐渐升高趋势(P<0.05).DCE-MRI表现结合定量参数评估宫颈癌患者临床分期的诊断准确率为95.28％,与病理检查结果一致性较高(P<0.01).随访3年,102例完成随访,生存率为71.57％.3年生存率高KTrans值患者低于中、低KTrans值患者(P<0.05).结论 DCE-MRI评估宫颈癌临床分期价值较高,其参数KTrans对宫颈癌患者生存情况有明显影响.

目的 探究MRI评估宫颈癌患者术前临床分期与病理诊断的一致性,并分析MRI定量参数预测预后的价值.方法 选取2020 年8 月—2022 年11 月92 例宫颈癌为研究对象,均行MRI检查.分析不同临床分期患者术前MRI表现特征,以术后病理诊断结果为"金标准",评价MRI表现特征评估宫颈癌术前临床分期与病理诊断的一致性.比较治疗后1 年不同预后患者术前MRI定量参数[速率常数(Kep)、血管细胞外间隙容积比(Ve)、容积转移常数(Ktrans)],分析MRI定量参数预测预后的价值.结果 MRI表现特征评估宫颈癌术前临床分期与病理诊断的一致性Kappa值为0.957(95％CI:0.847,1.045;P＜0.001),诊断符合率为95.65％.预后不良患者术前Kep、Ve、Ktrans均高于预后良好患者(P＜0.01).受试者工作特征曲线分析显示,术前Kep、Ve、Ktrans预测宫颈癌患者预后不良的曲线下面积分别为0.806、0.799、0.843.结论 MRI表现特征在评估宫颈癌患者术前临床分期方面具有较高可靠性,且术前MRI定量参数Kep、Ve、Ktrans对宫颈癌患者预后情况具有一定预测价值.

目的 探究血清和糖皮质激素调节蛋白激酶 3(SGK3)、盐诱导激酶 1(SIK1)在宫颈癌组织中的表达及其对患者预后的预测价值.方法 选取石家庄市妇幼保健院2017 年5 月至2020 年5 月期间手术治疗的150 例宫颈癌患者,通过免疫组化染色法检测宫颈癌组织及癌旁组织中SGK3、SIK1 的表达,另选取同期体检的150 例健康女性作为对照组,对比分析两组血清 SGK3、SIK1 的表达差异.采用 Pearson相关分析血清SGK3、SIK1 表达相关性,进一步通过COX回归分析宫颈癌患者预后的影响因素,受试者工作特征(ROC)曲线分析血清SGK3、SIK1 对宫颈癌患者预后的评估价值,Kaplan-Meier法分析宫颈癌组织SGK3、SIK1 表达与患者预后的关系.结果 与癌旁组织相比,宫颈癌组织SGK3 阳性表达率升高、SIK1 阳性表达率降低(P＜0.05);与对照组相比,宫颈癌患者血清SGK3 表达水平升高,SIK1 表达水平降低,二者之间呈现负相关(r =-0.347,P＜0.05);COX回归分析显示淋巴结转移、血清SGK3、SIK1 表达为宫颈癌患者预后的影响因素(P＜0.05).血清SGK3 预测宫颈癌患者预后的曲线下面积(AUC)为 0.802,灵敏度为 60.00%,特异度为 89.09%;血清SIK1 预测宫颈癌患者预后的AUC为0.737,灵敏度为75.00%,特异度为 67.27%;二者联合的AUC为 0.866,灵敏度为87.50%,特异度为71.82%.宫颈癌组织SGK3 阴性表达患者生存率(85.71%)高于SGK3 阳性表达患者生存率(65.96%),SIK1 阳性表达患者生存率(81.36%)高于SIK1 阴性表达患者生存率(63.74%)(P＜0.05).结论 宫颈癌患者癌组织和血清中SGK3 表达水平均上调、SIK1 表达水平均下调,宫颈癌组织SGK3阴性表达、SIK1 阳性表达患者生存率较高,血清SGK3、SIK1 水平对评估宫颈癌患者预后具有一定临床价值.

Objective:To investigate the relationship of the acute radiation reactions of totalbody irradiation before hematopoietic stem cell transplantation with the different total and fractionated doses of irradiation.Methods:The clinical data of 48 patients who underwent 6 MV X-ray total body irradiation pretreatment from May 2015 to December 2019 in Shijiazhuang Ping'an Hospital before undergoing hematopoietic stem cell transplantation were retrospectively analyzed. The patients were divided into 8 Gy group (12 cases), 10 Gy group (31 cases) and 12 Gy group (5 cases) according to the total radiation dose, and divided into 4 Gy/f group (17 cases) and 5 Gy/f group (31 cases) according to the fractionated radiation dose. Acute radiation reactions in the oral mucosa, pharynx, salivary glands, upper gastrointestinal tract, lower gastrointestinal tract and lung of patients in each group after radiotherapy were summarized and compared.Results:Acute pharyngeal reaction in the total radiation dose of 8 Gy group showed that 11 cases (91.7%) were grade 0 and 1 case (8.3%) was grade 1; in the total radiation dose of 10 Gy group, 10 cases (32.3%) were grade 0, 13 cases (41.9%) were grade 1, 4 cases (12.9%) were grade 2, 3 cases (9.7%) were grade 3, and 1 case (3.2%) was grade 4; in the total radiation dose of 12 Gy group, 2 cases (40.0%) were grade 0, 1 case (20.0%) was grade 1, 1 case (20.0%) was grade 2, and 1 case (20.0%) was grade 3. The severity of acute pharyngeal radiation reaction in the total radiation dose of 8 Gy group was better than that in the 10 Gy and 12 Gy groups, and the difference was statistically significant ( χ2 = 11.338, P = 0.003); there was no significant difference in the incidence of acute radiation reactions in other parts (all P > 0.05). Acute pharyngeal radiation reaction in the fractionated radiation dose of 4 Gy/f group showed that 13 cases (76.5%) were grade 0, 2 case (11.8%) was grade 1, 1 case (5.9%) was grade 2, and 1 case (5.9%) was grade 3; in the 5 Gy/f group, 10 cases (32.3%) were grade 0, 13 cases (41.9%) were grade 1, 4 cases (12.9%) were grade 2, 3 cases (9.7%) were grade 3, and 1 case (3.2%) was grade 4. The severity of acute pharyngeal radiation reaction in the fractionated radiation dose 4 Gy/f group was better than that in the 5 Gy/f group, and the difference was statistically significant ( Z = -2.606, P = 0.009); there was no significant difference in the incidence of acute radiation reactions in other parts (all P > 0.05). Conclusion:The total dose of 8 Gy and fractionated dose of 4 Gy/f in the total body irradiation before hematopoietic stem cell transplantation can alleviate the acute pharyngeal radiation reaction.