Xiong Zeng, Hu Cheng-ping, Liu Jin-kang, Lu Rong-li, Zhou Hui, Zhou Mo-ling, Chen Wei
Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhonghua Yi Xue Za Zhi. 2011 Nov 1;91(40):2824-7.
To investigate tumor vascularity by dual source volume perfusion computed tomography (VPCT) in advanced lung adenocarcinoma with positive EGFR-mutant and determine whether any of the VPCT parameters would predict the tumor response to gefitinib.
Twelve patients (5 males and 7 females, Median age: 53 years, range: 36 - 69 years) with advanced lung adenocarcinoma received VPCT scan. All patients with positive EGFR-mutant were confirmed by pathological biopsy. After a 6-week therapy of gefitinib, VPCT was repeated and the short-term effect evaluated by the RECIST criteria. The VPCT parameters (blood volume, blood flow and permeability surface) of 12 patients were compared with their differentiation grade and short-term effect.
Short-term effects were poor in those cases in whom BF increased after a 6-week of targeted therapy (P = 0.030). BF and PS at pre-therapy were negatively correlated with differentiation grade (r = -0.603, -0.694, P = 0.038, 0.012). There was a negative correlation between the rate of BF decline and differentiation grade (r = -0.686, P = 0.029); a negative correlation existed between the trend of BF and RECIST criteria (r = -0.707, P = 0.010). But there was no significant correlation with differentiation grade (P = 0.059). If the BF decline was considered effective, the dual source VPCT could predict the effect of RECIST criteria. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of VPCT was 100%, 66.7%, 83.3%, 75% and 100% respectively.
Dual source VPCT of advanced lung adenocarcinoma can assess effectively tumor vascularity and perfusion changes after the therapy of gefitinib. It is important in evaluating the response of targeted therapy in lung cancer.
采用双源容积灌注计算机断层扫描（VPCT）研究表皮生长因子受体（EGFR）突变阳性的晚期肺腺癌的肿瘤血管情况，并确定VPCT参数是否能预测吉非替尼的肿瘤反应。
12例晚期肺腺癌患者（5例男性，7例女性，中位年龄：53岁，范围：36 - 69岁）接受VPCT扫描。所有EGFR突变阳性患者均经病理活检确诊。经6周吉非替尼治疗后，重复VPCT扫描，并根据实体瘤疗效评价标准（RECIST）评估短期疗效。比较12例患者的VPCT参数（血容量、血流量和表面通透性）与其分化程度和短期疗效。
在经过6周靶向治疗后血流量增加的病例中，短期疗效较差（P = 0.030）。治疗前的血流量和表面通透性与分化程度呈负相关（r = -0.603，-0.694，P = 0.038，0.012）。血流量下降率与分化程度呈负相关（r = -0.686，P = 0.029）；血流量变化趋势与RECIST标准呈负相关（r = -0.707，P = 0.010）。但与分化程度无显著相关性（P = 0.059）。如果将血流量下降视为有效，则双源VPCT可预测RECIST标准的疗效。VPCT的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为100%、66.7%、83.3%、75%和100%。
晚期肺腺癌的双源VPCT可有效评估吉非替尼治疗后的肿瘤血管情况和灌注变化。这对评估肺癌靶向治疗反应具有重要意义。
