摘要
目的探讨磁共振成像(MRI)定量参数与子宫内膜癌患者脉管间隙浸润(LVSI)的相关性,为手术决策与个体化治疗提供影像学依据。方法回顾性分析2023年6月至2025年6月在南阳医学高等专科学校第一附属医院妇科收治确诊的90例子宫内膜癌患者,依据患者术后病理结果分为LVSI阳性组(n=45)和LVSI阴性组(n=45)。所有患者术前均行盆腔MRI检查,收集MRI相关指标。分析组间基本资料和MRI指标差异,通过方差膨胀因子、容忍度以及Pearson/Spearman相关分析进行组间差异指标的共线性判断,通过多因素Logistic分析进行影响子宫内膜癌患者脉管间隙浸润的影响因素分析。结果LVSI阳性组患者的肿瘤最大径、肿瘤体积、Ktrans、Kep及Ve值均显著高于LVSI阴性组(P<0.05),ADC值显著低于阴性组(P<0.05),且淋巴结肿大比例较高(P<0.05)。共线性分析后排除肿瘤体积变量,其余指标纳入多因素Logistic回归,结果显示肿瘤最大径增大(OR=2.085,P=0.002)及Ktrans值升高(OR=2.303,P=0.030)为子宫内膜癌患者LVSI的独立危险因素,而ADC值升高(OR=0.742,P=0.007)是LVSI的独立保护因素。结论多参数MRI在子宫内膜癌术前评估中具有重要价值,其中肿瘤最大径增大、ADC值降低和Ktrans升高或与子宫内膜癌患者出现LVSI密切相关。
Objective To investigate the association between quantitative magnetic resonance imaging(MRI)parameters and lymphovascular space invasion(LVSI)in patients with endometrial cancer.and to provide imaging-based evidence for surgical decision-making and individualized treatment.Methods A retrospective analysis was performed on 90 patients with endometrial cancer who were admitted to the Department of Gynecology.The First Affiliated Hospital of Nanyang Medical College.between June 2023 and June 2025 and were pathologically confirmed.According to postoperative pathological findings.patients were divided into an LVSI-positive group(n=45)and an LVSI-negative group(n=45).All patients underwent preoperative pelvic MRI.and MRI-related variables were collected.Differences in baseline characteristics and MRI parameters between the two groups were analyzed.Collinearity among variables showing between-group differences was assessed using variance inflation factor.tolerance.and Pearson/Spearman correlation analyses.Multivariable logistic regression analysis was then conducted to identify factors associated with LVSI in patients with endometrial cancer.Results Compared with the LVSI-negative group.the LVSI-positive group had significantly greater maximum tumor diameter and tumor volume.and significantly higher values of Ktrans.Kep.and Ve(P<0.05).while the apparent diffusion coefficient(ADC)was significantly lower(P<0.05).In addition.the LVSI-positive group had a higher proportion of lymph node enlargement(P<0.05).After collinearity assessment.tumor volume was excluded.and the remaining variables were entered into the multivariable logistic regression model.The results showed that an increased maximum tumor diameter(OR=2.085.P=0.002)and elevated Ktrans(OR=2.303.P=0.030)were independent risk factors for LVSI.whereas a higher ADC value(OR=0.742.P=0.007)was an independent protective factor.Conclusion Multiparametric MRI is of significant value for preoperative evaluation of endometrial cancer.An increased maximum tumor diameter.decreased ADC.and elevated Ktrans may be closely associated with the presence of LVSI in patients with endometrial cancer.
作者
叶子涵
刘士连
YE Zihan;LIU Shilian(Department of Gynecology,The First Affiliated Hospital of Nanyang Medical College,Nanyang Henan 467000,China)
出处
《临床研究》
2026年第2期9-12,共4页
Clinical Research
关键词
子宫内膜癌
脉管间隙浸润
磁共振成像
相关性分析
endometrial cancer
lymphovascular space invasion
magnetic resonance imaging
correlation analysis
