术前磁共振腹膜癌指数及CA125在预测卵巢癌热灌注化疗不良结局中的价值研究OA
The Value of Preoperative MRI Peritoneal Cancer Index and CA125 in Predicting the Adverse Outcome of Hyperthermic Intraperitoneal Chemotherapy for Ovarian Cancer
目的:探讨术前磁共振腹膜癌指数(MRI-PCI)及CA125在卵巢癌热灌注化疗(HIPEC)不良结局中的预测价值.方法:本研究收集了2018年2月至2024年5月期间,在宜昌市第二人民医院妇瘤科接受治疗的60例卵巢癌HIPEC患者术前MRI-PCI及CA125数据.所有患者均在肿瘤细胞减灭术后接受一次HIPEC治疗及随后5个周期的常规化疗.研究以确诊卵巢癌之日为随访起点,死亡为随访终点,采用Kaplan-Meier生存曲线分析患者生存时间.通过ROC曲线分析术前MRI-PCI及CA125在预测HIPEC不良结局方面的效能.结果:患者中位生存时间36个月,随访期间共有24例患者死亡,基于最大约登指数,术前MRI-PCI最佳截断值确定为8分时,此时预测HIPEC不良结局的敏感度为0.870,特异度为 0.887,曲线下面积为0.835.而CA125 最佳截断值为 984.38 U/mL时,其预测HIPEC不良结局的敏感度为 0.770,特异度为 0.735,曲线下面积为0.734.这些结果表明,术前MRI-PCI在预测HIPEC不良结局方面表现出更高的准确性.结论:当术前MRI-PCI达到或超过8分时,卵巢癌患者的预后往往不良.与CA125相比,MRI-PCI在预测HIPEC不良结局方面展现出更高的效能.这一发现对于临床决策具有重要意义,提示在制定治疗方案时应充分考虑MRI-PCI的评估结果,以便为患者提供更加个性化和有效的治疗.
Objective:To explore the predictive value of preoperative magnetic resonance peritoneal cancer index(MRI-PCI)and CA125 in adverse outcomes of hyperthermic intraperitoneal chemotherapy(HIPEC)for ovarian cancer.Methods:The study collected preoperative MRI-PCI and CA125 data from 60 patients with HIPEC ovarian cancer who received treatment in the Department of Gynecology and Oncology at the Second People's Hospital of Yichang from February 2018 to May 2024.All patients received one HIPEC treatment followed by five cycles of conventional chemotherapy after tumor cell reduction surgery.The study used the date of diagnosis of ovarian cancer as the follow-up starting point and death as the follow-up endpoint,and analyzed the patient's survival time using Kaplan-Meier survival curve.The study analyzed the efficacy of preoperative MRI-PCI and CA125 in predicting adverse outcomes of HIPEC through ROC curve analysis.Results:The median survival time of the patients was 36 months,and a total of 24 patients died during the follow-up period.Based on the maximum Youden's index,the optimal cut-off value for preoperative MRI-PCI was determined to be 8 points.At this time,the sensitivity,specificity,and area under the curve for predicting adverse outcomes of HIPEC were 0.870,0.887,and 0.835,respectively.When the optimal cutoff value of CA125 was 984.38 U/mL,its sensitivity for predicting adverse outcomes of HIPEC was 0.770,specificity was 0.735,and the area under the curve was 0.734.These results indicate that preoperative MRI-PCI demonstrates higher accuracy in predicting adverse outcomes of HIPEC.Conclusion:When preoperative MRI-PCI reaches or exceeds 8 points,the prognosis of ovarian cancer patients is often poor.Compared with CA125,MRI-PCI showed higher efficacy in predicting adverse outcomes of HIPEC.This discovery is of great significance for clinical decision-making,suggesting that the evaluation results of MRI-PCI should be fully considered when formulating treatment plans,in order to provide more personalized and effective treatment for patients.
谢晨;邹敏;马天文;郑杰;林国成
宜昌市第二人民医院 放射科,湖北 443000宜昌市第二人民医院 妇瘤科,湖北 443000宜昌市第二人民医院 放射科,湖北 443000宜昌市第二人民医院 放射科,湖北 443000宜昌市第二人民医院 放射科,湖北 443000
医药卫生
卵巢癌腹膜癌腹膜癌指数磁共振成像扩散加权成像
ovarian cancerperitoneal cancerperitoneal cancer indexmagnetic resonance imagingdiffusion-weighted imaging
《影像科学与光化学》 2026 (2)
150-156,7
2023年宜昌市医疗卫生研究项目(A23-1-054).
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