CAJ | 학술논문

目的采用超声造影灌注参数预测肝癌肝动脉插管化疗栓塞(TACE)的疗效.方法本院2008年1月至2010年12月的肿瘤直径≥5 cm单发肿瘤初诊肝癌69例,首次治疗为TACE.比较患者TACE术前、后肿瘤大小,按RECIST标准进行分组,部分缓解组(PR)21例,疾病稳定组(SD)17例,疾病进展组(PD)31例.采用SonoLiver软件分析肿瘤超声造影灌注曲线的曲线下面积(AUC)、平均渡越时间(mTT)、灌注指数(PI)、达峰时间(TTp)及峰值强度(IMX),采用Image Pro Plus软件分析肿瘤动脉期肿瘤灌注百分率.结果 AUC、mTT、PI、TTP及IMX在3组间差异无统计学意义(P＞0.05).PR组或SD组动脉期肿瘤灌注百分率比PD组大[(78.88±12.19)％,(72.93±15.68)％比(38.97±11.01)％,P＜o.05].以动脉期肿瘤灌注百分率小于50％为预测指标,筛选PD组病例,诊断符合率为88.4％(61/69),敏感性83.9％( 26/31),特异性92.1％(35/38).结论动脉期肿瘤灌注百分率有可能作为一个新的超声造影参数预测肝癌TACE的疗效.
목적 채용초성조영관주삼수예측간암간동맥삽관화료전새(TACE)적료효.방법 본원2008년1월지2010년12월적종류직경≥5 cm단발종류초진간암69례,수차치료위TACE.비교환자TACE술전、후종류대소,안RECIST표준진행분조,부분완해조(PR)21례,질병은정조(SD)17례,질병진전조(PD)31례.채용SonoLiver연건분석종류초성조영관주곡선적곡선하면적(AUC)、평균도월시간(mTT)、관주지수(PI)、체봉시간(TTp)급봉치강도(IMX),채용Image Pro Plus연건분석종류동맥기종류관주백분솔.결과 AUC、mTT、PI、TTP급IMX재3조간차이무통계학의의(P＞0.05).PR조혹SD조동맥기종류관주백분솔비PD조대[(78.88±12.19)％,(72.93±15.68)％비(38.97±11.01)％,P＜o.05].이동맥기종류관주백분솔소우50％위예측지표,사선PD조병례,진단부합솔위88.4％(61/69),민감성83.9％( 26/31),특이성92.1％(35/38).결론 동맥기종류관주백분솔유가능작위일개신적초성조영삼수예측간암TACE적료효.
Objective To predict the efficacy of transcatheter arterial chemoembolization(TACE) in patients with hepatocellular carcinoma (HCC) by using ultrasonographic perfusion paramctcrs.Methods Sixty-nine patients with primary diagnosis of HCC as having single tumor diameter of ≥5 cm and TACE as initial treatment were enrolled from Sun Yat- scn University Cancer Center between January 2008 and December 2010.Patients were divided into partial response group(PR,n=21 ),stable disease group(SD,n=17) and progressive disease group(PD,n=31 ),respectively,based on the RECIST standard and comparison of pre- and post-operative tumor size.Parameters of tumor ultrasonographic perfusion curve,including area under curve (AUC),mean transit time (mTT),perfusion index (PI),time to peak (TTP) and maximum intensity (IMX),were analyzed by using SonoLiver software,and the artcrial phase perfusion ratio was computed via Image Pro Plus software.Results Thc differences in AUC,mTT,PI,TTP and IMX did not reach statistical significance among groups (all P＞0.05).Group PR and SD yielded higher perfusion ratio in arterial phasc than group PD [ (78.88± 12.19)％,(72.93± 15.68)％ vs (38.97± 11.01 )％,P＜0.05].Arterial phase perfusion ratio ＜50％ as a predictor of patients with PD was associated with a diagnostic accuracy of 88.4％(61/69),sensitivity of 83.9％(26/31) and specificity of 92.1％(35/38).Conclusion Pcrfusion ratio in arterial phase may be a novel ultrasonographic perfusion parameter for the prediction of efficacy of TACE treatments in patients with HCC.