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目的 评价胃癌介入治疗疗效评价更为可靠的标准。方法 分析病理证实的１０４ 例无手术指征的胃癌患者（ 含术后复发） 、影像诊断胃癌同时检出其他部位转移而无病理诊断者４３ 例，行胃动脉内化疗栓塞、转移灶化疗栓塞。术后用ＣＴ、ＧＩ和胃镜随访病灶。采用ＣＯＸ 肿瘤生存模型进行生存随访。结果 １ ． 胃癌原发灶治疗后，明显的缩小占６０．８ ％ ，２３．２ ％ 无明显反应，１７％ 在治疗中途出现病灶增大或转移至其他部位；ＣＴ随访碘化油沉积越浓，占肿瘤体积比例越大，滞留时间越长，肿瘤缩小越明显。淋巴结和转移灶在动脉内化疗栓塞后均有程度不等的缩小。２ ．１４７ 例患者中，至今存活５７ 例。首次治疗距统计日已满１２ 月者８５ 例，大于１２ 月者７９ 例，占５３ ．７％ （７９／１４７）；距统计日２４ 月者９４ 例，生存期等于或大于３６ 月者１９ 例，占１２．９ ％ ；距统计日５ 年以上者３１ 例，存活５ 年以上者９ 例，占６１．２％ 。结论 胃癌病灶介入治疗评价应包括原发灶、转移灶和淋巴结的改变，单纯以大小改变不能准确反映治疗疗效，更为主要的是肿瘤内部结构的变化。同时作者提出非肿块病灶缩小率的评价标准。
Objective To evaluate the more reliable criteria for evaluating the efficacy of interventional therapy for gastric cancer. METHODS: A total of 104 patients with pathologically confirmed gastric cancer without recurrence (including postoperative recurrence) were enrolled in the study. Forty-three patients with pathological diagnosis of gastric cancer who had metastases from other sites but no pathological diagnosis were performed. Gastric arterial chemoembolization and metastatic tumor embolization were performed. Postoperative CT, GI and gastroscopy were used to follow the lesions. Cox tumor survival model was used for survival follow-up. Results 1. After treatment of primary gastric cancer, significant reduction accounted for 60.8 %, 23.2 % no significant response, 17% increased lesions or metastasized to other sites in the middle of treatment; CT follow-up iodized oil deposition more concentrated, accounting for tumor The larger the volume ratio and the longer the retention time, the more obvious the tumor shrinkage. Lymph nodes and metastases have varying degrees of reduction after arterial chemoembolization. 2. Of the 147 patients, 57 survived to date. For the first time, 85 patients had been treated for at least 12 months from the date of statistics, and 79 patients had been diagnosed more than 12 months, accounting for 53%. 7% (79/147); 94 cases from the statistical day of 24 months, 19 cases with a survival period equal to or greater than 36 months, accounting for 12.9%; 31 cases with more than 5 years of statistical day, surviving more than 5 years 9 Cases, accounting for 61.2%. Conclusions Evaluation of interventional therapy for gastric cancer lesions should include changes in primary tumors, metastases, and lymph nodes. Changes in size alone cannot accurately reflect the efficacy of treatment, and more importantly, changes in the internal structure of tumors. At the same time, the authors put forward the evaluation criteria for the reduction rate of non-tumor lesions.