Application Of Contrast Enhanced Transrectal Ultrasound In Evaluating The Efficacy Of Endostatin Combined With Concurrent Chemo-radiotherapy For Cervical Cancer

Objective 1.By analyzing the changes in Time Intensivity Curve(TIC)and tumor size(maximum diameter)before and after treatment in patients with Endostatin combined with concurrent chemo-radiotherapy.To explore the value of Contrast Enhanced Transrectal Ultrasound(CETRUS)in evaluating the effect of Endostatin combined with concurrent chemo-radiotherapy in cervical cancer.2.By comparing with normal uterine tissue,the characteristics of quantitative parameters of contrast-enhanced ultrasound in cervical cancer were analyzed.Methods From March 2019 to January 2021,we enrolled 35 patients with pathologically diagnosed cervical cancer in the First Affiliated Hospital of Guangxi Medical University,and the clinical stages of FIGO(2018)were locally advanced(stage IB3 and IIA2)and middle-advanced(stage IIB-IVA).Each patient underwent CETRUS and DCE-MRI before and after treatment.The efficacy was divided according to the maximum diameter change rate measured by DCE-MRI.The Region with the most obvious enhancement in the process of CETRUS was selected as the ROI(Region of Interest)to draw the TIC.The normal uterine tissue was used as the reference for quantitative analysis of the lesion TIC.The TIC parameters of lesions before and after Endostatin combined with CCRT were compared.Contrast the consistency of CETRUS and DCE-MRI in measuring the change of tumor maximum diameter before and after treatment.Results 1.Comparison of CETRUS before and after treatment :(1)CETRUS and DCE-MRI showed good consistency in the measurement of the maximum diameter of enhanced lesions before and after treatment.Only one sample,2.86%(less than 5%),exceeded the 95% consistency limit range;(2)The peak intensity and the area under the curve in the effective group were significantly decreased before and after treatment,while the peak reaching time and the mean crossing time were significantly prolonged before and after treatment(P<0.05).There was no significant difference in the value of tumor tissue before and after treatment in the invalid group(P>0.05).There was no significant difference in the values between the ineffective group and the effective group before treatment(P > 0.05),but there were significant differences in the values after treatment(P<0.05).2.The peak intensity and area under the curve of the tumor tissue of 35 patients with cervical cancer before Endostatin combined with concurrent chemo-radiotherapy were larger than that of normal uterine tissue,and the peak reaching time and average crossing time were shorter(P > 0.05).3.After Endostatin combined with concurrent chemo-radiotherapy,complete response and partial response were classified as effective group,while those without disease progression and those with stable disease were classified as ineffective group.In the effective group,there were 23 cases(65.7%),including 22 squamous cell carcinoma and 1adenocarcinoma.12 cases(34.3%)in the ineffective group,including 8squamous cell carcinoma and 4 adenocarcinoma.There were no statistically significant differences in age,tumor maximum diameter,histological differentiation and lymph node metastasis between the effective group and the ineffective group(P>0.05),but there were statistically significant differences in pathological types between the effective group and the ineffective group(P<0.05).Conclusion 1.The measurement and quantitative analysis of the maximum diameter of cervical cancer by contrast enhanced transrectal ultrasound are helpful to evaluate the efficacy of Endostatin combined with concurrent chemo-radiotherapy for cervical cancer.2.Contrast enhanced transrectal ultrasound and quantitative analysis are helpful in differentiating cervical cancer from normal uterine tissue.3.Pathological classification of cervical cancer may affect the efficacy of Endostatin combined with concurrent chemo-radiotherapy.