应用超声造影评价结直肠癌抗血管治疗早期效果的可行性研究

摘要

Objective To evaluate the value of quantitative assessment using contrast-enhanced ultrasound in the diagnosis of colorectal cancer after anti-angiogenic therapy.Methods The clinical data of 80 patients with colorectal cancer were analyzed retrospectively.All patients were treated with an anti-angiogenic targeting drug (FOLFOX + bevacizumab regimen) for 6 cycles of treatment,2 weeks per 1 cycle.According to the standard of curative effect evaluation of modified solid tumor (mRECIST standard),58 cases were in effective group and 22 cases in ineffective group.All patients received contrast-enhanced ultrasound before and after treatment with 2 cycles.Four blood perfusion parameters were obtained from ultrasound contrast quantitative analysis software,namely peak intensity (PI),peak time (TTP),area under curve (AUC) and slope of rise (Pw).The quantitative parameters of two groups were recorded and the percentage change before treatment and after treatment of 2 cycles was analyzed.Results There was no significant difference in PI,TTP and AUC between the two groups before and after anti-angiogenic treatment (P ＞ 0.05).Before treatment the Pw in the effective group was significantly higher than that in the ineffective group (P ＜ 0.05),and there was no significant difference between the two groups after the treatment of 2 cycles (P ＞ 0.05).The percentage changes of PI and Pw in the two groups before and after treatment were significantly different (P ＜ 0.05).Conclusion The percentage changes of PI and Pw in contrast-enhanced ultrasound were different in the early stage of anti-angiagenic therapy,which suggests that contrast-enhanced ultrasound is of some value in evaluation of early treatment.%目的 探讨应用超声造影评价结直肠癌患者抗血管靶向治疗早期效果的价值.方法 回顾性分析本院收治的80例结直肠癌患者的临床资料,所有患者均为经抗血管靶向药物(FOLFOX+贝伐单抗方案)治疗6个周期,2周为1个周期,治疗结束后按照改良实体瘤疗效评价标准(mRECIST标准)分为有效组58例与无效组22例,所有患者在治疗前、治疗2个周期后经超声造影检查,利用超声造影定量分析软件得出四个血流灌注参数,分别为峰值强度(PI)、达峰时间(TTP)、曲线下面积(AUC)、上升斜率(Pw),记录两组定量参数,分析治疗前、治疗2个周期后定量参数变化百分数,从而判断治疗效果.结果 两组抗血管治疗前后PI、TTP、AUC比较均无统计学意义(均P＞0.05).治疗前有效组Pw显著高于无效组(P＜0.05),治疗2个周期后两组差异无统计学意义(P＞0.05).两组治疗前后PI及Pw变化百分数比较均有显著差异(均P＜0.05).结论 超声造影定量参数PI及Pw变化百分数在抗血管治疗早期有明显差异,提示超声造影评估早期治疗疗效有一定应用价值.