摘要
目的探讨18F-FDG SPECT/CT(18F-FDG coincidence single photon emission computed tomography/multi-detector computed tomography,18F-FDG SPECT/CT)所测定T/B值在胃癌临床疗效评价的价值。方法对31例未治疗的新发的原发性胃癌患者化疗前后进行MDCT增强扫描与18F-FDG SPECT/CT断层显像并测定T/B值。根据患者MDCT的疗效判定结果 ,初步探讨18F-FDG SPECT/CT的T/B值进行疗效评价的标准。结果 18F-FDG SPECT/CT中的T/B值下降率R△T/B与肿瘤最大径之和的下降率R△MD存在显著的直线相关(相关系数Rs=0.867,P<0.001);18F-FDG SPECT/CT中的R△T/B预测胃癌疗效的ROC曲线图的面积为0.943,其准确率为94.3%。若分别设R△T/B为35%、40%为基线,判定客观缓解OR(Objective remission,OR,CR+PR)的灵敏度分别为100%、85.7%,特异度94.1%、100%,阳性预测值93.3%、100%,阴性预测值100%、89.5%;判定有效率RR的结果分别为48.4%、38.7%。结论胃癌T/B值的改变率进行疗效评价具有较高的准确性,我们推荐T/B值下降35%以上作为临床判定客观缓解、无缓解的分界点。
Objective To Study the value of in 18F-FDG SPECT/CT （18F-FDG coincidence single photon-emission computed tomography/multi-detector computed tomography） in the evaluation of treatment response in gastric cancer. Methods MDCT （multi-detector computed tomography） enhancement scanning and 18F-FDG SPECT/CT was performed in 31 untreated patients with diagnosed gastric cancer. Then, chemotherapy with FOLFOX4 4Cycles was administrated on the 31 patients. 2 weeks after four Cycles of chemotherapy, both MDCT and 18F-FDG SPECT were performed in 31 patients.Criterion in MDCT was used to evaluate the treatment response. Then, the value of T/B was discussed by the treatment response.Results Kappa coefficient of the values of R△T/B [1-（T/B）after chemotherapy/（T/B）before chemotherapy] of 18 F-FDG SPECT/CT and R△MD （1-MaxiDiameterafter chemotherapy/MaxiDiameterbefore chemotherapy） of MDCT is 0.867（P0.01）.The accuracy of R△T/B to predict the treatment response is 94.3%. If we make the base line of R△T/B as 35%, The sensitivity, specificity, positive predictive value,negative predictive value of 18F-FDG SPECT/CT were 100%, 94.1%,93.3% and 100% respectively. If R△T/B is 40%,the results are 85.7%,100%,100% and 89.5% respectively. Conclusion The changed rate of the value of T/B in 18F-FDG SPECT/CT in gastric cancer is accurate and feasible. We recommend the value of T/B decrease more than 35% as the demarcation of Objective remission and No remission.
出处
《肿瘤防治研究》
CAS
CSCD
北大核心
2010年第6期679-682,共4页
Cancer Research on Prevention and Treatment
关键词
胃肿瘤
X线计算机体层成像
放射性核素显像
氟放射性同位素
疗效
Gastric Neoplasms
X-ray computed tomography
Radionuclide imaging
Fluorine radioisotopes
Treatment Response
作者简介
赖灿辉（1982-），男，硕士，住院医师，主要从事中西医结合肿瘤内科治疗
