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剪切波速度在结直肠癌肝转移化疗后作为潜在预后因素的初步研究。

Shear-wave velocity for colorectal cancer liver metastases as a potential prognostic factor after chemotherapy: a preliminary study.

机构信息

Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, 03080, South Korea.

Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, 03080, South Korea; Institute of Radiation Medicine, Seoul National University College of Medicine, Jongno-gu, Seoul, 03080, South Korea.

出版信息

Clin Radiol. 2021 Mar;76(3):224-232. doi: 10.1016/j.crad.2020.09.027. Epub 2021 Jan 2.

Abstract

AIM

To evaluate whether shear-wave velocity (SWV) can be used for predicting the prognoses of patients with colorectal cancer liver metastases (CRLMs) after chemotherapy.

MATERIALS AND METHODS

Our institutional review board approved this prospective study, and written informed consent was obtained. SWV of CRLMs were obtained using point shear-wave elastography using acoustic radiation force impulse from 25 patients prior to and 2, 7, and 14 days after chemotherapy. Progression-free survival (PFS) after chemotherapy was estimated using the Kaplan-Meier method. The Cox proportional hazard regression model was used to determine significant predictive factors for PFS. For measurement reproducibility, an additional 37 patients with CRLMs were enrolled and assessed using intraclass correlation coefficients (ICCs).

RESULTS

After chemotherapy, 10 and 15 patients were classified into responder and non-responder groups, respectively. The estimated 1- and 3-year PFS values in the whole cohort were 36% and 8%, respectively. A decrease in the SWV value on day 2 relative to the initial value was a significant predictive factor for better PFS outcome (hazard ratio = 0.20, 95% confidence interval = 0.07-0.57, p=0.003). The estimated 1 and 3-year PFS rates were 66.7% and 22.2%, respectively, in nine patients with decreased SWV values on day 2 and significantly higher than 18.8% and 0% of 16 patients with increased SWV values on day 2. The ICC value of SWV of CRLMs in the additional 37 patients was 0.823 (95% CI = 0.685-0.905), indicating good agreement.

CONCLUSION

SWV values of CRLMs could provide prognostic information in patients with CRLMs treated with chemotherapy, as decreased SWV values on day 2 after chemotherapy was a significant predictive factor for better PFS.

摘要

目的

评估剪切波速度(SWV)能否用于预测化疗后结直肠癌肝转移(CRLM)患者的预后。

材料与方法

本研究经机构审查委员会批准,患者均签署了知情同意书。采用声辐射力脉冲弹性成像技术,在化疗前及化疗后 2、7、14 天,对 25 例 CRLM 患者的 SWV 进行检测。采用 Kaplan-Meier 法估计化疗后的无进展生存期(PFS)。采用 Cox 比例风险回归模型确定 PFS 的显著预测因素。为了评估测量的可重复性,另外纳入 37 例 CRLM 患者,并采用组内相关系数(ICC)进行评估。

结果

化疗后,10 例和 15 例患者分别被归类为应答者和无应答者。全队列的估计 1 年和 3 年 PFS 值分别为 36%和 8%。与初始值相比,化疗后第 2 天 SWV 值下降是 PFS 较好的显著预测因素(风险比=0.20,95%置信区间=0.07-0.57,p=0.003)。在 9 例化疗后第 2 天 SWV 值下降的患者中,估计 1 年和 3 年 PFS 率分别为 66.7%和 22.2%,明显高于 16 例化疗后第 2 天 SWV 值升高的患者(1 年和 3 年 PFS 率分别为 18.8%和 0%)。另外 37 例患者的 CRLM-SWV 的 ICC 值为 0.823(95%置信区间=0.685-0.905),表明一致性良好。

结论

SWV 值可提供化疗后 CRLM 患者的预后信息,化疗后第 2 天 SWV 值下降是 PFS 较好的显著预测因素。

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