目的：探讨超声造影（CEUS）定量分析在结直肠癌肝转移辅以贝伐单抗联合细胞毒性化疗及仅细胞毒性化疗早期疗效评价中的应用价值。方法：将28 例结直肠癌肝转移患者分成贝伐单抗联合mFOLFOX6 治疗组与mFOLFOX6 治疗组，每组各14 例。于第1~4 次化疗前1 d 行常规超声及CEUS，采用动态造影定量分析软件，记录患者肝脏病灶的各项定量参数，根据实体瘤疗效评价标准（RECIST）最终结果，分别比较两治疗组中有效患者与无效患者第1 次化疗前1 d 与第2 次化疗前1 d 病灶定量参数变化百分数的差异。结果：贝伐单抗联合mFOLFOX6 治疗组有效患者与无效患者病灶定量参数峰值强度（PI）变化百分数差异有统计学意义（P=0.03），余参数差异无统计学意义（均P>0.05）；mFOLFOX6 治疗组有效患者与无效患者病灶各参数变化百分数比较差异均无统计学意义（均P>0.05）。结论：CEUS 定量参数PI 对于结直肠癌肝转移贝伐单抗联合细胞毒性化疗早期疗效评价有一定应用价值。
Quantitative analysis of contrast-enhanced ultrasonography for evaluation of early response of colorectal cancer liver metastasis to chemotherapy
Objective: To determine the application value of quantitative analysis of contrast-enhanced ultrasonography (CEUS) in evaluation of early response of colorectal cancer liver metastasis to bevacizumab plus cytotoxic chemotherapy or cytotoxic chemotherapy alone. Methods: Twenty-eight patients with colorectal cancer liver metastasis were designated to bevacizumab plus mFOLFOX6 treatment group and mFOLFOX6 alone treatment group, with 14 cases in each group. Conventional ultrasound and CEUS were performed 1d prior to the first four administrations of chemotherapy, and quantitative parameters of liver metastases were recorded by using contrast dynamic software. Based on the final results assessed according to Response Evaluation Criteria in Solid Tumors (RECIST), the differences in percentage change of the quantitative parameters of the liver lesions between 1d prior to first-course chemotherapy and 1d prior to second-course chemotherapy were compared between responders and non-responders of the two groups, respectively. Results: The percentage change of lesion quantitative parameter peak intensity (PI) was statistically different (P=0.03), but that of all other parameters showed no statistical difference between responders and nonresponders in bevacizumab plus mFOLFOX6 treatment group (all P>0.05); no statistical difference was noted in percentage change of lesion quantitative parameters between responders and non-responders in mFOLFOX6 alone treatment group (all P>0.05). Conclusion: CEUS quantitative parameter PI has certain application value in evaluation of early response of colorectal cancer liver metastasis to bevacizumab plus cytotoxic chemotherapy.