本文選題：子宮頸癌 + 宮頸上皮內(nèi)瘤變��； 參考：《廈門大學(xué)》2014年碩士論文

【摘要】：目的本研究旨在探討3.0T氫質(zhì)子磁共振波譜技術(shù)('H-magnetic resonance spectroscopy,'H-MRS)及磁共振擴(kuò)散加權(quán)成像(diffusion weighted imaging, DWI)對(duì)宮頸癌及宮頸上皮內(nèi)瘤變(cervical intraepithelial neoplasia, CIN)患者診斷價(jià)值。 方法1.選取32例宮頸病變患者(包括14例宮頸中分化癌、9例宮頸低分化癌、9例宮頸上皮內(nèi)瘤變(CIN))以及31例健康志愿者進(jìn)行3.0T磁共振的單體素波譜掃描及磁共振擴(kuò)散加權(quán)成像(DWI)掃描,宮頸病變均經(jīng)病理證實(shí),定量分析膽堿(cho3.2ppm)、甘油三酯-CH_2(lip1.3ppm)及ADC值。 2.分別對(duì)病例組與正常對(duì)照組；正常對(duì)照組、宮頸CIN組、宮頸浸潤(rùn)癌組；不同分化類型的宮頸病變患者(宮頸CIN、中分化癌及低分化癌)間cho峰、lip峰、ADC值進(jìn)行統(tǒng)計(jì)學(xué)分析。最后應(yīng)用受試者工作特征曲線(receive operating characteristic curve, ROC曲線)分析,找到正常組與病例組間合理的cho峰、lip峰及ADC值閡值。 結(jié)果1.31例正常對(duì)照組、32例病例組cho峰值(峰下面積均值)分別為0.61±0.42,3.24±1.87,病例組cho峰明顯升高,兩組間差異具有統(tǒng)計(jì)學(xué)意義(P0.05)；正常對(duì)照組、病例組lip峰的峰下面積均值分別為0.67±0.46、3.48±1.94,病例組lip峰明顯升高,兩組間差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。 2.31例正常對(duì)照組、9例宮頸上皮內(nèi)瘤變組(CIN組)、23例宮頸浸潤(rùn)癌組cho峰值分別為0.61±0.42、0.85±0.56、4.98±2.42,lip峰值分別為0.67±0.46、1.17±0.78、4.52±2.61,宮頸CIN組cho、lip峰稍高于正常對(duì)照組,但兩組間差異無統(tǒng)計(jì)學(xué)意義(P0.05),宮頸浸潤(rùn)癌組cho、lip峰明顯高于正常對(duì)照組及宮頸CIN組,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)；。 3.9例宮頸CIN組、14例宮頸中分化癌組、9例宮頸低分化癌組cho峰的峰下面積均值分別為0.85±0.56、4.93±2.75、5.01±2.89；宮頸CIN組cho峰明顯低于宮頸中分化癌組及宮頸低分化癌組,且差異均有統(tǒng)計(jì)學(xué)意義(P0.05),宮頸低分化癌組cho峰稍高于宮頸中分化癌組,但兩組間差異無統(tǒng)計(jì)學(xué)意義(P0.05)；宮頸CIN組、宮頸中分化癌組、宮頸低分化癌組lip峰的峰下面積均值分別為1.17±0.78、1.98±0.62、5.79±2.05；宮頸低分化癌組lip峰明顯高于宮頸CIN組及宮頸中分化癌組,且差異有統(tǒng)計(jì)學(xué)意義(P0.05),宮頸中分化癌組lip峰稍增高于宮頸CIN組,但兩組間差異無統(tǒng)計(jì)學(xué)意義(P0.05)； 4.31例正常對(duì)照組、32例病例組、23例宮頸浸潤(rùn)癌組、9例宮頸CIN組、14例宮頸中分化癌組、9例宮頸低分化癌組的ADC值平均值分別為(1.49±0.25)xl0-3mm2/s、(0.95±0.22)xl0-3mm2/s、(0.83±0.18)xl0-3mm2/s、(1.06±0.14)xl0-3mm2/s、(O.88±.16)xlO-3mm2/s、(0.79±0.12)xl0-3mm2/s、病例組ADC值明顯低于正常對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；正常對(duì)照組、宮頸CIN組及宮頸浸潤(rùn)癌組的ADC值依次減低,且差異均有統(tǒng)計(jì)學(xué)意義(P0.05)；宮頸CIN組、宮頸中分化癌組及宮頸低分化癌組的ADC值依次減低,但只有低分化癌組與宮頸CIN組的差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論1、病例組cho峰、lip峰均明顯升高,峰下面積均值明顯高于正常對(duì)照組；2、宮頸CIN組、宮頸浸潤(rùn)癌組cho峰、lip峰均升高,但宮頸CIN組升高不明顯：3、不同分化程度的宮頸癌cho峰升高程度也不同,宮頸低分化癌升高程度最明顯,宮頸中分化癌升高程度僅次于宮頸低分化癌,宮頸CIN組僅見輕度升高；4、不同分化程度的宮頸癌lip峰升高程度也不同,宮頸低分化癌升高程度最明顯,宮頸CIN組僅見輕度升高,宮頸中分化癌組僅稍高于宮頸CIN組；5、病例組及浸潤(rùn)癌組ADC值明顯低于正常對(duì)照組；宮頸CIN組、宮頸中分化癌組及宮頸低分化癌組的ADC值依次減低。
[Abstract]:Objective the purpose of this study was to explore the diagnostic value of 3.0T'H-magnetic resonance spectroscopy ('H-MRS) and magnetic resonance diffusion-weighted imaging (diffusion weighted imaging, DWI) for cervical cancer and cervical intraepithelial neoplasia (cervical intraepithelial neoplasia).
Methods 1. 32 cases of cervical lesions (including 14 cases of cervical differentiated carcinoma, 9 cases of cervical low differentiation cancer, 9 cases of cervical intraepithelial neoplasia (CIN)) and 31 healthy volunteers were scanned by 3.0T magnetic resonance spectroscopy and magnetic resonance diffusion-weighted imaging (DWI). The cervical lesions were all confirmed by pathology, quantitative analysis of choline (cho3.2ppm), Gump Oil three ester -CH_2 (lip1.3ppm) and ADC value.
2. the case group and the normal control group, the normal control group, the cervical CIN group, the cervical infiltrating cancer group, the CHO peak, the lip peak and the ADC value between the different types of cervical lesions (cervical CIN, middle differentiated and low differentiated carcinoma) were statistically analyzed. Finally, the working characteristic curves of the subjects were applied (receive operating characteristic curve, ROC). The CHO peak, lip peak and ADC value between normal group and case group were found.
Results in the 1.31 normal control group, the peak value of CHO (mean below peak area) in 32 cases was 0.61 + 0.42,3.24 + 1.87 respectively. The CHO peak in the case group was significantly increased, and the difference between the two groups was statistically significant (P0.05). The mean value of the area under the peak area of the lip peak in the case group was 0.67 + 0.46,3.48 + 1.94 respectively. The lip peak of the case group was significantly elevated, and the two groups were significantly increased. The difference was statistically significant (P0.05).
2.31 cases of normal control group, 9 cases of cervical intraepithelial neoplasia (CIN group), 23 cases of cervical invasive cancer group Cho peak of 0.61 + 0.42,0.85 + 0.56,4.98 + 2.42, lip peak of 0.67 + 0.46,1.17 + 0.78,4.52 + 2.61, cervical CIN CHO, lip peak a little higher than the normal control group, but there is no statistically significant difference between the two groups (P0.05), cervical infiltrating cancer group Cho The IP peak was significantly higher than that of the normal control group and the cervical CIN group, and the difference was statistically significant (P0.05).
3.9 cases of cervical CIN group, 14 cases of cervical differentiation cancer group, 9 cases of cervical low differentiation cancer group Cho peak area average of 0.85 + 0.56,4.93 + 2.75,5.01 + 2.89, cervical CIN group Cho peak significantly lower than the cervical differentiation and cervical low differentiation cancer group, and the difference was statistically significant (P0.05), cervical low differentiation cancer group Cho peak was slightly higher than the cervix In the medium differentiated carcinoma group, there was no significant difference between the two groups (P0.05), and the average value of the lip peak area in the cervical CIN group, the cervical differentiated carcinoma group and the low differentiated cervical cancer group was 1.17 + 0.78,1.98 + 0.62,5.79 2.05, and the low differentiated cervical cancer group was significantly higher than that of the cervical CIN group and the cervical middle differentiated carcinoma group, and the difference was statistically significant (P0.05). The lip peak in the moderately differentiated cervical cancer group was slightly higher than that in the cervical CIN group, but there was no significant difference between the two groups (P0.05).
4.31 normal control group, 32 case group, 23 cervical infiltrating cancer group, 9 cervical CIN group, 14 cervical middle differentiated carcinoma group and 9 cervical low differentiated carcinoma group, the average value of ADC value was (1.49 + 0.25) xl0-3mm2/s, (0.95 + 0.22) xl0-3mm2/s, (0.83 + 0.18) xl0-3mm2/s, (1.06 +.16) xlO-3mm2/s, (O.88 +.16) xlO-3mm2/s, xl0-3mm2/s, disease (O.88 +.16) xl0-3mm2/s, disease The ADC value of the case group was significantly lower than that of the normal control group, the difference was statistically significant (P0.05). The normal control group, the ADC value of the cervical CIN group and the cervical invasive cancer group decreased in turn, and the difference was statistically significant (P0.05). The ADC value of the cervical differentiated carcinoma group and the cervical low differentiated carcinoma group decreased in sequence, but only the low differentiated cancer group and the cervical C. The difference in group IN was statistically significant (P0.05).
Conclusion 1, the CHO peak and lip peak of the case group were significantly higher than those of the normal control group. 2, the cervical CIN group, the CHO peak of the cervical infiltrating cancer group and the lip peak were all elevated, but the increase of the cervical CIN group was not obvious: 3, the degree of CHO peak in the cervical cancer with different degree of differentiation was different, the level of cervical low differentiation cancer was the most obvious, the differentiation of cervix in the cervix was in the cervical differentiation. The level of cancer in the cervical CIN group was only slightly higher than that of the low differentiated cervical carcinoma. 4, the level of lip peak of cervical cancer with different degree of differentiation was also different, the level of cervical low differentiation cancer was the most obvious, the CIN group in the cervix was slightly higher, the cervical differentiation cancer group was only slightly higher than that of the uterine cervix CIN group, and the ADC value of the case group and the infiltrating cancer group was obviously lower than that of the ADC. In normal control group, the ADC values of cervical CIN group, cervical squamous cell carcinoma group and cervical poorly differentiated cancer group decreased in turn.
【學(xué)位授予單位】：廈門大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.33;R445.2

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