磁共振成像2026，Vol.17Issue(3)：60-67,8.DOI:10.12015/issn.1674-8034.2026.03.009
血氧水平依赖MRI在评估宫颈鳞癌新辅助化疗治疗反应及预后危险因素中的价值
The value of blood oxygen level dependent MRI in assessing treatment response and prognostic risk factors in cervical squamous cell carcinoma undergoing neoadjuvant chemotherapy
摘要
Abstract
Objective:To investigate the value of the effective transverse relaxation rate(R2*)derived from blood oxygen level dependent magnetic resonance imaging(BOLD-MRI)in assessing the response to neoadjuvant chemotherapy(NACT)and prognostic risk factors in cervical squamous cell carcinoma.Materials and Methods:This study retrospectively enrolled 64 patients with cervical squamous cell carcinoma who underwent surgery after NACT at our institution.All patients underwent BOLD-MRI before and after NACT.Tumor histopathological features,including lymph node metastasis(LNM),lymphovascular space invasion(LVSI),and depth of stromal invasion,were recorded based on postoperative pathology.According to Response Evaluation Criteria in Solid Tumors version 1.1(RECIST 1.1),patients were classified into a partial response(PR)group(n=54)and a stable disease(SD)group(n=10).Inter-observer agreement was assessed using the intra-class correlation coefficient(ICC).The Mann-Whitney U test or independent samples t-test was used to compare R2*values between groups.To evaluate the predictive value and correlation of R2*parameters with tumor histopathological features and response to NACT,binary logistic regression and Pearson or Spearman correlation analysis were employed,respectively.Furthermore,receiver operating characteristic(ROC)curves were plotted to assess the predictive performance of R2*values,and internal validation was performed using the bootstrap method.Results:Both post-NACT R2*(R2*post)and the change in R2*(ΔR2*)demonstrated predictive value for LVSI,LNM,and depth of stromal invasion(all P＜0.05).Area under the ROC curve(AUC)analysis indicated that R2*post exhibited superior predictive performance compared to ΔR2*for LVSI,stromal invasion depth,and prognostic risk factors(adjusted AUCs:0.862 vs.0.792,0.742 vs.0.687,and 0.749 vs.0.699,respectively),with optimal cutoff values of 21.44 Hz,21.68 Hz,and 21.68 Hz,respectively.In contrast,for LNM,ΔR2*showed better predictive efficacy than R2*post(adjusted AUC:0.792 vs.0.738),with an optimal cutoff value of 1.145 Hz.Multivariate analysis further confirmed that R2*post was an independent predictor of LVSI,and ΔR2*was an independent predictor of LNM.Conclusions:R2*post and ΔR2*may serve as potential imaging biomarkers for assessing treatment response to NACT and prognostic risk factors in cervical squamous cell carcinoma.Lower values of these parameters are associated with unfavorable clinical outcomes.关键词
宫颈鳞癌/新辅助化疗/治疗反应/磁共振成像/血氧水平依赖/预后/危险因素Key words
cervical squamous cell carcinoma/neoadjuvant chemotherapy/treatment response/magnetic resonance imaging/blood oxygen level dependent/prognosis/risk factor分类
医药卫生引用本文复制引用
牟亚男,张静,庞雅萱,王祺钰,丁梓轩,王刚,殷亮..血氧水平依赖MRI在评估宫颈鳞癌新辅助化疗治疗反应及预后危险因素中的价值[J].磁共振成像,2026,17(3):60-67,8.基金项目
Natural Science Foundation of Gansu Province(No.21JR1RA086) （No.21JR1RA086）
Teaching Backbone Cultivation Project of Lanzhou University(No.lzuyxcx-2022-218) （No.lzuyxcx-2022-218）
The 2025 Intramural Fund of the First Hospital of Lanzhou University(No.ldyyyn2025-95) （No.ldyyyn2025-95）
Education and Teaching Reform Research Project of Lanzhou University(No.202512). 甘肃省自然科学基金项目(编号:21JR1RA086) （No.202512）
兰州大学教学骨干培育项目(编号:lzuyxcx-2022-218) （编号:lzuyxcx-2022-218）
兰州大学第一医院2025年度院内基金项目(编号:ldyyyn2025-95) （编号:ldyyyn2025-95）
兰州大学教育教学改革研究项目(编号:202512) （编号:202512）
