经阴道实时超声弹性成像技术在宫颈癌及癌前病变鉴别诊断中的应用价值探讨

目的探讨经阴道实时超声弹性成像技术在宫颈癌及癌前病变鉴别诊断中的应用价值。方法回顾性分析2018年5月至2019年6月我院收治且经手术或宫颈活检确诊的62例宫颈癌、60例宫颈癌前病变患者的临床资料,同期纳入58例宫颈正常体检者作为对照组。比较三组超声弹性成像评分、超声弹性成像表现情况,并分析不同截断值下超声弹性成像评分诊断宫颈癌的敏感性、特异性及准确性。结果宫颈癌组超声弹性成像评分为3、4、5分比例、应变率比值均显著高于癌前病变组(P<0.01),且宫颈癌组评分为3、4、5分比例亦高于对照组(P<0.01);将评分≥3分作为截断值时,超声弹性成像可有效提高宫颈癌的诊断敏感性、特异性及准确性,其诊断敏感性、特异性及准确性分别为93.55%、91.53%、92.22%;且超声弹性成像诊断宫颈癌病灶长径、横径及前后径与手术结果比较差异无统计学意义(P>0.05)。结论经阴道实时超声弹性成像技术可有效鉴别诊断宫颈癌与宫颈癌前病变,能准确评估病变大小,临床应用价值较高,可作为早期诊断宫颈癌的一种无创手段。

Application value of transvaginal real-time ultrasound elastography in the differential diagnosis of cervical cancer and precancerous lesions

Objective To investigate the application value of transvaginal real-time ultrasound elastography in the differential diagnosis of cervical cancer and precancerous lesions.Methods The clinical data of 62 patients with cervical cancer and 60 cases with cervical precancerous lesions admitted to our hospital from May 2018 to June 2019 and confirmed by surgery or cervical biopsy were retrospectively analyzed.During the same period,58 cases with normal cervical examination were included as a control group.The ultrasound elastography scores and ultrasound elastography performance among the three groups were compared,and the sensitivity,specificity and accuracy of ultrasound elastography scores in the diagnosis of cervical cancer at different cutoff values were analyzed.Results The proportions of ultrasound elastography scores of 3,4 and 5 and the ratio of strain rate in the cervical cancer group were significantly higher than those in the precancerous lesion group(P<0.01).The proportion of ultrasound elastography score was 3,4 and 5 in the cervical cancer group was also higher than that of the control group(P<0.01).When the score≥3 was used as the cutoff value,ultrasound elastography can effectively improve the diagnostic sensitivity,specificity and accuracy of cervical cancer.The diagnostic sensitivity,specificity and accuracy are 93.55%,91.53%and 92.22%,respectively.There was no statistically significant difference between the ultrasound elastography in the diagnosis of length,width,and front and back diameters of lesions of cervical cancer(P>0.05).Conclusion Transvaginal real-time ultrasound elastography can effectively differentiate and diagnose the cervical cancer from cervical precancerous lesions,accurately assess the size of the lesions,and has high clinical value.It can be used as a noninvasive method in the early diagnosis of cervical cancer.