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目的探讨18-氟脱氧葡萄糖-正电子发射计算机断层扫描(18FDG-PET)的早期代谢疗效与RECIST标准评价的胃肠道肿瘤化疗最佳客观疗效的关系,评价其在化疗反应监测中的临床价值。方法不可切除的局部晚期和晚期胃肠道肿瘤患者入组,行全身化疗。按RECIST标准和SUV值标准(2疗程化疗后SUV值下降>30%)分别评价肿瘤客观疗效。用计数资料的χ2检验和相关分析检验比较2疗程后18FDG-PET代谢缓解与RECIST标准的最佳客观疗效是否具有一致性(SPSS10.0)。结果不可切除的局部晚期胃肠道肿瘤3例,晚期胃肠道肿瘤27例。18FDG-PET代谢缓解与按RECIST标准评价的最佳客观疗效具有明显的一致性(P=0.004)。18FDG-PET预测胃肠道肿瘤化疗最佳客观疗效的敏感性、特异性、阳性预测值和阴性预测值分别是91.7%、66.7%、64.7%和92.3%。结论 18FDG-PET可以预测局部晚期和晚期胃肠道肿瘤化疗的最佳客观疗效,在化疗反应监测中具有一定的临床价值。
Objective To investigate the relationship between the early curative effect of 18FDG-PET and the optimal objective effect of gastrointestinal cancer chemotherapy evaluated by RECIST standard and to evaluate its clinical value in the monitoring of chemotherapy response . Methods Patients with locally advanced and late-stage gastrointestinal cancer who were unresectable were enrolled in the study and received systemic chemotherapy. According to RECIST standard and SUV standard (SUV value decreased by> 30% after 2 courses of chemotherapy), the objective tumor efficacy was evaluated respectively. Chi-square test and correlation analysis of count data were used to test whether the best objective effect of 18FDG-PET metabolic remission and RECIST standard was consistent after two courses of treatment (SPSS10.0). Results of unresectable local advanced gastrointestinal cancer in 3 cases, advanced gastrointestinal cancer in 27 cases. 18FDG-PET Metabolic Relief Consistent with the best objective response to RECIST criteria (P = 0.004). The sensitivity, specificity, positive predictive value and negative predictive value of 18FDG-PET in predicting the optimal objective efficacy of gastrointestinal cancer chemotherapy were 91.7%, 66.7%, 64.7% and 92.3%, respectively. Conclusion 18FDG-PET can predict the best objective effect of locally advanced and advanced gastrointestinal cancer chemotherapy and has certain clinical value in the monitoring of chemotherapy response.