晚期胰体癌HIFU消融效果与CT靶皮距的相关性

目的探讨晚期胰体癌HIFU消融效果与CT靶皮距的相关性。方法将HIFU消融体积比>30%定为A组,即存在与HIFU相关的消融;≤30%定为B组,即不明确存在与HIFU相关的消融。根据上述分组,对20例晚期胰体癌肿物消融效果与CT靶皮距的相关性进行分析。结果 A组与B组之间CT靶皮距差异有统计学意义(P<0.05),且CT靶皮距每增加1cm,消融效果降低0.31倍;ROC曲线显示,当CT靶皮距为7.15cm时,其预测消融效果的敏感度为80.00%,特异度为70.00%,曲线下面积为0.81(P=0.02)。结合临床,将7cm作为CT靶皮距的分界值,预测消融效果的敏感度和特异度分别为77.80%和72.70%,OR值为9.33。结论晚期胰体癌HIFU消融效果与CT靶皮距呈负相关;CT靶皮距等于7cm可作为胰体癌HIFU治疗的适应证选择界值。

Correlation between ablation effect and CT target skin distance in HIFU on advanced pancreatic body cancer

Objective To explore the correlation between ablation effect and CT target skin distance (TSD) of advanced pancreatic body carcinoma in high intensity focused ultrasound (HIFU) therapy. Methods Positive ablation associated with HIFU was the tumor ablated over 30% (group A), otherwise it was negative ablation (group B). The correlation between ablation effect and CT TSD was analyzed based on 20 patients of adenocarcinoma of pancreatic body in the late stage that received HIFU therapy. Results The difference of CT TSD between group A and group B was significant (P<0.05).Increasing of CT TSD by 1 cm would cause reduction of tumor ablation effect by 0.31. ROC curve predicted that when CT TSD was 7.15 cm, the sensitivity and specificity of ablation effect was 80.00% and 70.00%, respectively, and AUC was 0.81 (P=0.02). With reference to clinical practice, 7 cm was set as the critical value for CT TSD in HIFU therapy. Taking this value of CT TSD, the sensitivity and specificity of tumor ablation effect was 77.80% and 72.70%, respectively, OR=9.33. Conclusion The ablation effect negatively relates to CT TSD in HIFU therapy for pancreatic body carcinoma; 7 cm of CT TSD can be set as the critical value for HIFU indications.