Objective To evaluate the clinical utility of computed tomography (CT) value to assess tumor blood supply in patients with local late stage of gastric cancer. Methods Since September 2013, the patients with local late stage of gastric cancer admitted to our hospital have been studied. After CT examination of association of cancer with adjacent organs and blood vessels, the patients who could be resected were treated with radical dissection of gastric cancer. The others who could not be resected were treated with preoperative chemotherapy before surgical treatment. CT values in lesions in both portal venous phase and plain phase were calculated and adjusted to aorta CT(AACT) values. The patients with preoperative chemotherapy were administered intra-arterial and intravenous chemotherapy combined with oral S-1 and the chemotherapeutic response was evaluated. Results By November 2017, 300 cases with gastric cancer were treated inclu-ding 179 patients with direct surgery and 121 cases with preoperative chemotherapy. The ages of patients were(59.03±10.82) years, and AACT value was 0.574 1±0.118 3. There was no significant difference in AACT values of tumor in gender, tumor location and general type (P>0.05). In terms of histological types, there were statistically significant differences in AACT values of pathological type between well and poor differentiated adenocarcinoma (P=0.024), between well differentia-ted adenocarcinoma and signet ring cell carcinoma (P=0.001) and between poor differentiated adenocarcinoma and signet ring cell carcinoma (P=0.030), respectively. There were 87 cases in tumor response group with AACT value (0.628 6±0.192 2) and 34 cases in non-response group with AACT value (0.494 5±0.245 1) and significant difference in AACT values was present between two groups (P<0.001). Preoperative chemotherapy had better effect for the tumor with abundant blood supply. The threshold 0.516 4 of AACT value had sensitivity 80.5% and specificity 67.6% of chemotherapy effect respectively. The area under the receiver operating characteristic curve was 0.758. Conclusions The well differentiated gastric cancer would be more abundant blood supply. The patients with local unresectable gastric cancer with high AACT value may have abundant tumor blood supply and have better results from preoperative chemotherapy and opportunity of surgery.
YE Chen, XU Qinmei, XIANG Xiaosong, ZHOU Changsheng, LI Guoli
. Evaluation of tumor blood supply and efficacy of preoperative chemotherapy using CT value in patients with gastric cancer[J]. Journal of Surgery Concepts & Practice, 2019
, 24(01)
: 45
-50
.
DOI: 10.16139/j.1007-9610.2019.01.010
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