强化造影定量灌注参数对子宫内膜癌的预后价值

目的:评估超声造影（contrast-enhanced ultrasonography，CEUS）定量指标对子宫内膜癌的预后价值。方法:2015年05月至2016年05月期间，共纳入112例行子宫内膜癌手术治疗的患者，记录术前CEUS的定量指标，包括增强强度（enhancement intensity，EI）、上升时间（rise time，RT）和增强率（enhancement rate，ER）以及其他临床指标。采用单因素和多因素COX分析，分析术后总生存期（overall survival，OS）和无复发生存期（recurrence-free survival，RFS）的危险因素。结果:根据ROC曲线得出ER的最佳临界值为1.8 dB/s，Kaplan-Meier生存曲线表明，高ER水平患者的RFS和OS比低ER水平的患者差（RFS:P＜0.001；OS:P=0.028）。在多因素COX分析中，ER是子宫内膜癌患者RFS（HR=1.82，95%CI:1.08~4.23，P＜0.001）和OS（HR=2.08，95%CI:1.01~5.77，P=0.018）的独立危险因素。结论:CEUS定量检测指标ER是子宫内膜癌术后患者生存的有效预测因子，可指导患者选择个性化的治疗方案。

Prognostic value of quantitative perfusion parameters by contrast-enhanced ultrasonography for endometrial cancer

Objective:To assess the prognostic value of quantitative parameters of contrast-enhanced ultrasonography (CEUS) for endometrial cancer.Methods:A total of 112 patients with endometrial cancer were included from May 2015 to May 2016.Preoperative quantitative parameters of CEUS,including enhancement intensity (EI),rise time (RT) and enhancement rate (ER),as well as other clinical indicators were recorded.Risk factors of the overall survival (OS) and recurrence-free survival (RFS) were analyzed using univariate and multivariate COX analysis.Results:The optimal threshold for ER based on the ROC curve was 1.8 dB/s.Kaplan-Meier survival showed that patients with high ER level had worse RFS and OS than those with low ER level (RFS:P＜0.001.OS:P=0.028).In multivariate COX analysis,ER was an independent risk factor of RFS (HR=1.82，95%CI:1.08~4.23,P＜0.001) and OS (HR=2.08,95%CI:1.01~5.77,P=0.018) in patients with endometrial cancer.Conclusion:The CEUS quantitative parameter ER is a valid predictor of postoperative survival in patients with endometrial cancer and it can guide patients to choose personalized treatment.