胃癌原发灶体积改变在胃癌术前化疗疗效评价中的应用价值  

Value of primary tumor volumetry in predicting tumor response to 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24期60-62,72,共4页Journal of Clinical Medicine in Practice

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

摘　　要：目的观察胃癌原发灶体积改变在胃癌术前化疗疗效评价中的应用价值。方法回顾性分析150例接受术前化疗和D2胃癌根治术的患者的临床资料。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。观察化疗前后胃癌原发灶体积减小百分率与Becker评分及患者生存的关系。结果化疗后胃癌原发灶体积较化疗前显著减小(P<0.001)。化疗后原发灶体积减少百分率与Becker评分密切相关(R=0.5672,P=0.002)。ROC曲线分析提示,化疗前后原发灶体积减少百分率对鉴别化疗有效与无效的患者有重要价值,曲线下面积(AUC)为0.845,评价化疗有效的界值点被设定为体积减少达到55%。结论胃癌原发灶体积减少程度可以应用于评价胃癌化疗疗效。Objective To observe the value of primary tumor volumetry in predicting tumor response to preoperative chemotherapy in gastric cancer patients. Methods A total of 150 gastric cancer patients who received preoperative chemotherapy and D2 radical resection were analyzed retro-spectively. Pathologic tumor response was evaluated according to Becker score. The percentage change in primary tumor volume between pre-and post - chemotherapy was calculated, and correlation between pathologic tumor regression and survival quality was analyzed. Ability of primary tumor volumetry to distinguish pathologic responders and non-responders was evaluated by receiver operating characteristic （ROC） curve analysis. Results The volume of primary gastric lesion significantly decreased after neo-adjuvant chemotherapy （P 〈 0. 001 ）. Percentage reduction rate of primary tumor volume in the pathologic responder group was significantly larger than the non-responder group. There was a significant association between primary tumor volume reduction rate and pathologic tumor regression grade （ Becker score）. ROC curve analysis showed that volume change of primary gastric lesion was a potential parameter to differentiate pathologic responders from non - responders （ AUC = 0. 845 ）, and the optimal cutoff level was determined to be a reduction of ≥55%. Furthermore, responders based on the volumetric criteria had a better overall survival than non - responders. Conclusion Primary tumor volumetry could be used to assess tumor response to preoperative chemotherapy in gastric cancer patients.

关 键 词：胃癌 术前化疗 体积测量 RECIST标准 

分 类 号：R735.2[医药卫生—肿瘤]