Evaluation Of The Efficacy Of Multimodal MR Imaging Combined With Serum Sensitive Factors In The Treatment Of Cervical Cancer With Radiotherapy And Chemotherapy

BackgroundCervical cancer ranks third in the incidence of female reproductive system malignancies worldwide,with the fourth highest mortality rate.Synchronous chemoradiotherapy is an important means of treating advanced cervical cancer.MRI can not only provide tumor morphological information for the clinic,but also use magnetic resonance diffusion-weighted imaging?DWI?and dynamic enhancement?DCE?techniques to evaluate concurrent chemoradiotherapy based on its ADC value and blood supply information before tumor morphogenesis changes.Efficacy.Multimodal magnetic resonance imaging combined with serum sensitivity factor detection can further improve the accuracy of the evaluation of the efficacy of concurrent chemoradiotherapy,and provide a basis for clinical development of the best treatment options.Objective1.Using Conventional MRI,DWI and DCE to record the changes of tumor volume,quantitative parameters of DWI and DCE at different time points before and after concurrent chemoradiotherapy in advanced cervical cancer,then to evaluate the efficacy of Multimodal MRI.2.To record the changes of serum sensitivity factors at different time points before and after concurrent chemoradiotherapy for advanced cervical cancer,and to evaluate the value of serum sensitivity factors in evaluating the efficacy and prognosis of cervical cancer.3.Combined analysis of serum sensitive factors and effective parameters of DWI and DCE quantitative parameters,and explored the efficacy of multimodal magnetic resonance imaging combined with serum sensitive factors on the efficacy of concurrent chemoradiotherapy for cervical cancer.MethodA total of 54 patients with cervical squamous cell carcinoma confirmed by pathology confirmed stage IIb-IVa were treated with concurrent chemoradiotherapy.All patients were treated 2 weeks before concurrent chemoradiotherapy,14 days after the start of concurrent chemoradiotherapy,and 1 after treatment.The pelvic routine MRI,multi-b value DWI,DCE examination and related serum sensitivity factors were measured.The patients were followed up for 10-24 months after treatment.The routine pelvic cavity MRI and DWI were performed.The efficacy of concurrent chemoradiotherapy for cervical cancer was grouped according to the residual,recurrence and distant metastasis of the primary lesion.The statistical analysis software used SPSS22.0 to analyze the difference of each parameter value between the nodes before and after treatment,and used the paired sample t test;analyzed the difference of the parameter values between different groups before and after treatment,using independent samples t test.The joint probability was calculated by Logistic regression model.The ROC curve analysis was used to evaluate the curative effect.The largest area under the curve was the best predictor.The test level was 0.05.P?0.05 was considered statistically significant.Result1.2 weeks before CCRT,ADC₁₀₀₀,Ktrans and SCCAg are high-efficiency markers for evaluation of cervical cancer.AUC=0.940,95%CI:0.828-1.000.2.Day 14 after CCRT,ADC₁₀₀₀,Ktrans and CYFRA21-1 are high-efficiency markers for evaluation of cervical cancer.AUC=0.965,95%CI:0.908-1.000.3.1 month after the end of CCRT,ADC₁₀₀₀,Ve,Ktrans,SCCAg and CYFRA21-1 are high-efficiency markers for evaluation of cervical cancer.AUC=0.954,95%CI:0.886-1.000.ConclusionMultimodal MRI combined with serum sensitivity factors can provide an objective basis for clinical guidance in the early evaluation of the efficacy and prognosis of synchronous chemotherapy in the middle and late stages of cervical cancer.