%0 Journal Article
%T DWI在直肠癌术前同步放化疗疗效预测中的作用
%A 陆艳荣
%A 刘艳
%A 张瑾熔
%A 曹燕珍
%A 朱丽娜
%A 肖楠
%J 肿瘤防治研究
%D 2019
%R 10.3971/j.issn.1000-8578.2019.18.1385
%X 摘要 目的 探讨DWI在局部进展期直肠癌（LARC）术前同步放化疗疗效预测中的作用。方法 将经内镜活检病理证实的LARC患者44例纳入分析。将患者术后病理分期与治疗前临床分期作比较，分为T-降期组和T-未降期组，比较放化疗前后以及组间ADC值、组间ADC变化量（ΔADC）以及变化率（ADC%）之间的差异，并根据ROC曲线得出疗效预测的最佳临界ADC值。结果 44例患者中7例（15.9%）获得pCR。患者同步放化疗前后ADC值差异有统计学意义（P=0.000）。同步放化疗前T-降期组ADC值明显低于T-未降期组，差异有统计学意义（P=0.007）。同步放化疗后T-降期组ADC值明显高于T-未降期组，差异有统计学意义（P=0.005）。T-降期组同步放化疗后ΔADC及ADC%均高于T-未降期组，差异有统计学意义（Z=-5.53, P=0.000; P=-5.09, P=0.000）。取治疗前ADC值0.87×10-3 mm2/s作为预测T分期是否降期的临界值，ROC曲线下面积为0.697（95%CI: 0.539~0.855），预测疗效的敏感度为87.5%，特异性为55.0%。结论 通过对ADC的定量分析可早期预测直肠癌患者对术前同步放化疗的敏感度，对术前同步放化疗疗效的判断也有一定的价值
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%U http://www.zlfzyj.com/CN/abstract/abstract9375.shtml