Wang Z, Liu L, Song Y X, Zhang H, She W, Qian Y W
Department of Orthopedics, Gansu Provincial Hospital, Lanzhou 730000, China.
Zhonghua Yi Xue Za Zhi. 2020 Apr 7;100(13):1012-1016. doi: 10.3760/cma.j.cn112137-20190722-01625.
To discuss application of apparent diffusion coefficient (ADC) in diffusion weighted imaging (DWI) combined with serum alkaline phosphatase (ALP) and tumor specific growth factor (TSGF) in evaluating neoadjuvant chemotherapy for osteosarcoma. A total of 78 patients with osteosarcoma who were admitted to People's Hospital of Gansu from January 2016 to August 2018 were collected as study subjects. All the patients were treated with neoadjuvant chemotherapy. Before chemotherapy, at the end of 4 courses of chemotherapy, before and after surgery, MRI examination and detection of serum ALP and TSGF were performed. According to results of pathological examination, the 78 patients were divided into effective chemotherapy group (54) and ineffective chemotherapy group (24). ADC values, levels of serum ALP and TSGF, change rates of ADC values and levels of serum ALP and TSGF were compared between the two groups. The value of ADC value combined with serum ALP and TSGF in evaluating curative effect of neoadjuvant chemotherapy for osteosarcoma was analyzed with receiver operating characteristic curve (ROC). After chemotherapy, ADC value in effective chemotherapy group increased significantly, while levels of serum ALP and TSGF decreased significantly (7.269, 18.778, 23.237, all 0.05). Only after surgery, ADC value, levels of serum ALP and TSGF increased or decreased significantly in ineffective chemotherapy group (7.316, 15.083, 20.930, all 0.05). Before and after chemotherapy, change rates of ADC values and levels of serum ALP and TSGF in effective chemotherapy group were all significantly higher than those in ineffective chemotherapy group (7.604, 5.482, 5.048, all 0.05). ROC curve analysis showed that area under the curve (AUC) of ADC value combined with serum ALP and TSGF for evaluating curative effect of neoadjuvant chemotherapy was 0.912, which was higher than that of ADC value, ALP, TSGF, ADC value combined with ALP, ADC value combined with TSGF (0.847, 0.787, 0.701, 0.885, 0.876, respectively). ADC value combined with serum tumor markers ALP and TSGF is reliable in evaluating curative effect of neoadjuvant chemotherapy for osteosarcoma.
探讨表观扩散系数（ADC）在扩散加权成像（DWI）中联合血清碱性磷酸酶（ALP）和肿瘤特异性生长因子（TSGF）评估骨肉瘤新辅助化疗疗效中的应用。收集2016年1月至2018年8月在甘肃省人民医院收治的78例骨肉瘤患者作为研究对象。所有患者均接受新辅助化疗。化疗前、化疗4个疗程结束时、手术前后，均行MRI检查及血清ALP和TSGF检测。根据病理检查结果，将78例患者分为化疗有效组（54例）和化疗无效组（24例）。比较两组患者的ADC值、血清ALP和TSGF水平、ADC值及血清ALP和TSGF水平的变化率。采用受试者工作特征曲线（ROC）分析ADC值联合血清ALP和TSGF评估骨肉瘤新辅助化疗疗效的价值。化疗后，化疗有效组ADC值显著升高，血清ALP和TSGF水平显著降低（分别为7.269、18.778、23.237，均P<0.05）。仅在手术后，化疗无效组ADC值、血清ALP和TSGF水平有显著升高或降低（分别为7.316、15.083、20.930，均P<0.05）。化疗前后，化疗有效组ADC值及血清ALP和TSGF水平的变化率均显著高于化疗无效组（分别为7.604、5.482、5.048，均P<0.05）。ROC曲线分析显示，ADC值联合血清ALP和TSGF评估新辅助化疗疗效的曲线下面积（AUC）为0.912，高于ADC值、ALP、TSGF、ADC值联合ALP、ADC值联合TSGF（分别为0.847、0.787、0.701、0.885、0.876）。ADC值联合血清肿瘤标志物ALP和TSGF评估骨肉瘤新辅助化疗疗效可靠。
