肿瘤代谢体积对肠型胃癌新辅助化疗效果评价的价值  

THE VALUE OF METABOLIC TUMOR VOLUME IN ESTIMATING NEOADJUVANT CHEMOTHERAPY FOR INTESTINAL-TYPE GASTRIC CANCER

作　　者：王康[1] 赵园园[1] 何信佳[1] 张碧媛[1] 于丽[1] 

机构地区：[1]青岛大学医学院附属医院肿瘤科,山东青岛266003

出　　处：《齐鲁医学杂志》2013年第2期121-123,共3页Medical Journal of Qilu

摘　　要：目的探讨肿瘤代谢体积(MTV)对肠型胃癌新辅助化疗(NAC)疗效评价的价值。方法回顾性分析35例均经病理证实为肠型胃癌病人。所有病人在接受胃癌NAC后行根治性手术切除,并在NAC前后均行两次氟标记脱氧葡萄糖PET-CT检查分析代谢反应。通过Spearman相关分析计算原发灶最大标准摄取值(SUV-max)、MTV降低率与病理反应的相关性。采用ROC曲线分析比较SUVmax与MTV对预测NAC后肿瘤组织病理反应的价值。结果 NAC前后MTV降低率与病理反应呈显著正相关(r=0.73,P<0.05)。NAC前后SUV-max、MTV降低率ROC曲线下面积分别为0.76和0.93,两者间差异具有显著性(Z=1.99,P<0.05)。以MTV降低49.4%作为评价化疗有效的阈值,其预测病理反应有效的灵敏度为88.2%、特异度为88.9%。结论对于肠型胃癌病人,MTV能够较准确地预测NAC后病理反应,可作为疗效评价的一项敏感、有效的指标。Objective To explore the value of metabolic tumor volume(MTV) in estimating neoadjuvant chemotherapy(NAC) for intestinal-type gastric cancer(ITGC).Methods A retrospective analysis was done in 35 patients with ITGC confirmed pathologically.All of them underwent radical resection after NAC.FDG PET-CT was performed before and after NAC for assessment of metabolic reaction.Using the Spearman correlation test,the correlation between SUVmax,MTV reduction rate and pathologic reaction was calculated.By employing ROC Curve analysis,the value of SUVmax and MTV in predicting pathologic response of cancer tissue after NAC was compared.Results Before and after NAC,the reduction rate of MTV was positively correlated with histopathologic response(r=0.73,P<0.05);The reduction rate of SUVmax and MTV in the area under ROC Curve was 0.76 and 0.93,respectively,the difference between them was significant(Z=1.99,P<0.05).When MTV decreased by 49.4% was set to be an effective threshold for assessing chemotherapeutic efficacy,its sensitivity and specificity in predicting histopathologic response was 88.2% and 88.9%,respectively.Conclusion MTV can be used-as a sensitive and effective index-to more accurately predict the pathologic response in patients with ITGC after NAC.

关 键 词：胃肿瘤 新辅助化疗 病理反应 正电子发射断层显像术 

分 类 号：R735.2[医药卫生—肿瘤]