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目的研究表观弥散系数(apparent diffusion coefficients,ADC)在临床消化道肿瘤肝脏转移癌化学治疗疗效判断中的作用。方法选取2006年4月至2007年4月期间北京大学人民医院胃肠外科收治的消化道肿瘤肝转移患者10例,其中结直肠癌肝转移患者8例,胃癌肝转移及食管癌肝转移各1例;所有患者均进行化学治疗。具体方案为:8例结直肠癌肝转移患者中4例行FOLFOX6、3例行XELOX、1例行FOLFIRI,胃癌肝转移者行ECF,食管癌肝转移者行DCF;应用GE MEDICAL SYSTEMS HD EXCITE 1.5 T在行化学治疗之前和之后1个月进行磁共振弥散加权成像(duffusion weight i maging,DWI)扫描,测定ADC值;实体瘤疗效评价标准(re-sponse evaluation criteria in solid tumors,RECIST)评价肿瘤化疗疗效。结果化学治疗前ADC值低于9.04×10-4mm2/s的肝转移癌的疗效明显好于ADC值高于9.04×10-4mm2/s的肝转移癌;对化学治疗有效的肝转移癌(6/10)治疗前的ADC值明显低于对化学治疗无效的肝转移癌(4/10),P=0.033;肝转移癌患者行化学治疗后1个月,ADC值升高的肝转移癌对化学治疗敏感。结论化学治疗前ADC值低的肝转移癌对化学治疗敏感;化学治疗后ADC值增高的肝转移癌对化学治疗敏感。
Objective To study the role of apparent diffusion coefficients (ADC) in judging the curative effect of chemotherapeutic drugs on liver metastatic carcinoma of gastrointestinal cancer. Methods From April 2006 to April 2007, Peking University People ’s Hospital Gastrointestinal Surgery admitted gastrointestinal tumors in patients with liver metastases in 10 cases, of which 8 cases of colorectal cancer liver metastases, liver metastasis of gastric cancer and liver metastasis of esophageal 1 Example; All patients undergo chemotherapy. The specific protocol was as follows: 4 cases of FOLFOX6, 3 cases of XELOX, 1 case of FOLFIRI, 4 cases of hepatic metastasis of gastric cancer and 4 cases of hepatic metastasis of colorectal cancer were enrolled in this study. GE MEDICAL SYSTEMS HD EXCITE 1.5 T was performed before and after the chemotherapeutic treatment by magnetic resonance diffusion weighted imaging (duffusion weight i maging, DWI) scan to determine the ADC value; re-sponse evaluation criteria in solid tumors (RECIST) Chemotherapy effect. Results The efficacy of hepatic metastases with ADC value less than 9.04 × 10-4mm2 / s before chemotherapy was significantly better than that of hepatic metastases with ADC values above 9.04 × 10-4mm2 / s. Chemotherapy-effective hepatic metastases (6 / 10) ADC value before treatment was significantly lower than that of liver metastasis (4/10), which was ineffective in chemotherapy, P = 0.033; patients with liver metastasis who had metastasis of ADC at 1 month after chemotherapy Chemotherapy sensitive. Conclusions The metastatic carcinoma with low ADC value before chemotherapy is sensitive to chemotherapeutic treatment and the metastatic carcinoma with increased ADC value after chemotherapy is sensitive to chemotherapy.