64层螺旋CT灌注成像在进展期胃癌血管生成及新辅助化疗疗效评估OA

Objective:To explore the application value of 64-slice spiral CT perfusion imaging in assessing angiogenesis in advanced gastric carcinoma and the efficacy of neoadjuvant chemotherapy.Methods:A total of 107 patients with advanced gastric carcinoma admitted to the hospital from September 2020 to March 2023 were selected as the subjects.All patients underwent 64-slice spiral CT examinations before neoadjuvant chemotherapy and after 2 cycles of chemotherapy to obtain CT perfusion imaging parameters of gastric carcinoma tissues and adjacent normal tissues.Microvessel density(MVD)and vascular endothelial growth factor(VEGF)protein expression levels were assessed by the immunohistochemical method.Pearson correlation analysis was used to analyze the correlation between CT perfusion imaging parameters and MVD,VEGF.Receiver operating characteristic(ROC)curves were used to analyze the value of CT perfusion imaging parameters in assessing the efficacy of neoadjuvant chemotherapy.Results:Blood flow(BF),blood volume(BV),and vascular permeability surface(PS)in gastric carcinoma tissues were higher than those in adjacent tissues(P<0.001),and were positively correlated with MVD and VEGF(P<0.001).After neoadjuvant chemotherapy,the reduction rates of BF,BV and PS in the the pathological complete remission(pCR)group were higher than those in the non-pathological complete remission(NpCR)group(P<0.001).And the reduction rates in the effective group were also higher than those in the ineffective group(P<0.001).ROC analysis showed that the area under the curve(AUC)values for predicting the efficacy of neoadjuvant chemotherapy based on the reduction rates of BF,BV and PS were 0.813,0.762 and 0.842,respectively.Conclusion:64-slice spiral CT perfusion imaging parameters can reflect the angiogenesis status of advanced gastric carcinoma and accurately assess the pathological response and clinical efficacy after neoadjuvant chemotherapy,which is helpful for guiding individualized neoadjuvant chemotherapy.