Choi标准在胃癌术前化疗疗效评价中的应用  

Value of Choi criteria in efficacy evaluation of preoperative chemotherapy in patients with gastric cancer

作　　者：刘坤[1] 李国立[2] 范朝刚[2] 汤黎明[1] 许建[3] 

机构地区：[1]南京医科大学附属常州第二人民医院普外科,江苏常州213003 [2]南京军区南京总医院普通外科研究所,江苏南京210002 [3]南京军区南京总医院医学影像科,江苏南京210002

出　　处：《实用临床医药杂志》2016年第11期54-58,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省常州市应用基础研究计划(CJ20130024);南京军区面上课题(12ma087)

摘　　要：目的观察Choi标准在胃癌术前化疗疗效评价中的应用价值。方法回顾性分析60例接受术前化疗和D2胃癌根治术的患者的临床资料。按照RECIST及Choi标准划分为化疗有效组和无效组。参照Becker评分行病理学化疗反应评价。采用Kaplan-Meier法绘制生存曲线。比较RECIST及Choi标准在预测病理学化疗疗效及患者生存的差异。结果按照RECIST标准,化疗有效21例,无效39例。根据Choi标准,化疗有效35例,无效25例。RECIST和Choi标准预测病理学化疗疗效的敏感度分别为52.5%和87.5%,特异度均为100%。14例RECIST标准评价为化疗无效而Choi标准评价为化疗有效的患者,其疾病进展时间和总体生存时间与21例RECIST及Choi标准均评价为化疗有效的患者无显著差异,并明显优于RECIST及Choi标准均评价为化疗无效的患者。结论与RECIST相比,Choi标准能更好地评价胃癌术前化疗的病理学反应及患者的生存获益。Objective To explore the value of Choi criteria in efficacy evaluation of preoperative chemotherapy in patients with gastric cancer. Methods Clinical materials of 60 patients with preoperative chemotherapy and D2 radical gastrectomy for gastric cancer were analyzed retrospectively. All the patients were divided into effective chemotherapy group（ EC group） and non-effective chemotherapy group（ NEC group） according to RECIST and Choi criteria. Pathologic response to chemotherapy was evaluated by Becker score,and the survival curve was drawn by Kaplan-Meier method. Differences between RECIST and Choi criteria in predicting the curative effect and survival of patients with pathological chemotherapy were compared. Results According to RECIST,there were21 cases of responders and 39 cases of non-responders. According to Choi criteria,there were 35 cases of responders and 25 cases of non-responders. The sensitivities of RECIST and Choi standard in predicting the efficacy of pathological chemotherapy were 52. 5% and 87. 5% respectively,and the specificity was 100% in both groups. In the 14 patients defined as non-responders by RECIST but responders by Choi criteria,their PFS and OS were similar to the 21 patients defined as responders by RECIST and Choi,and their PFS and OS were significantly better than those of patients defined as non-responders by RECIST and Choi. Conclusion Compared with RECIST criteria,Choi criteria is much better in predicting pathologic tumor response and clinical outcome in gastric cancer patients with preoperative chemotherapy.

关 键 词：胃癌 术前化疗 Choi标准 RECIST标准 

分 类 号：R735.2[医药卫生—肿瘤]