论文部分内容阅读
目的探讨MSCT增强扫描在评价胃癌新辅助化疗疗效方面的应用价值。方法收集进行新辅助化疗(EOF或FOLFOX6方案2-3周期)的进展期胃癌患者32例,化疗前后均行MSCT增强扫描,对胃癌进行T分期并测量肿瘤密度,采用酶联免疫吸附法测量VEGF的含量变化,化疗后1周内所有患者手术切除肿瘤,术后对照病理疗效分成病理有效组和病理无效组。结果 MSCT增强扫描对胃癌化疗后T分期总的准确性为78.1%;病理有效组和病理无效组在化疗前后肿瘤密度降低率分别为22.62%±14.12%和2.87%±19.39%(P=0.006),差异有统计学意义;化疗前后肿瘤密度变化与VEGF变化呈显著相关(r=0.79)。如果将肿瘤密度降低率13.65%作为评价化疗有效的阈值,其预测病理评价有效的敏感度是81.8%,特异性81%。结论MSCT测量肿瘤密度降低率可以作为预测进展期胃癌患者化疗疗效较为准确的指标。
Objective To investigate the value of MSCT in evaluating the efficacy of neoadjuvant chemotherapy for gastric cancer. Methods Thirty-two patients with advanced gastric cancer who underwent neoadjuvant chemotherapy (EOF or FOLFOX6 regimen 2-3 cycles) were enrolled in this study. MSCT scanning was performed before and after chemotherapy. T-staging was performed on gastric cancer and tumor density was measured. Enzyme-linked immunosorbent assay Of the changes in the amount of chemotherapy within 1 week after surgery in all patients with surgical resection of the tumor, the pathological efficacy after surgery divided into pathological effective group and pathological invalid group. Results The overall accuracy of MSCT enhanced T lymph node biopsy was 78.1% in patients with gastric cancer before and after chemotherapy. The reduction rates of tumor density before and after chemotherapy were 22.62% ± 14.12% and 2.87% ± 19.39%, respectively (P = 0.006) , The difference was statistically significant. The changes of tumor density before and after chemotherapy were significantly correlated with the changes of VEGF (r = 0.79). If the tumor density reduction rate of 13.65% as a threshold value for the evaluation of chemotherapy, its effective prediction pathological sensitivity was 81.8%, specificity 81%. Conclusion The decrease of tumor density by MSCT can be used as a more accurate index to predict the effect of chemotherapy in patients with advanced gastric cancer.