[Application of apparent diffusion coefficient combined with serum tumor markers detection in evaluating neoadjuvant...

Objective: To discuss application of apparent diffusion coefficient (ADC) in diffusion weighted imaging (DWI) combined with serum alkaline phosphatase (ALP) and tumor specific growth factor (TSGF) in evaluating neoadjuvant chemotherapy for osteosarcoma. Methods: A total of 78 patients with osteosarcoma who were admitted to People's Hospital of Gansu from January 2016 to August 2018 were collected as study subjects. All the patients were treated with neoadjuvant chemotherapy. Before chemotherapy, at the end of 4 courses of chemotherapy, before and after surgery, MRI examination and detection of serum ALP and TSGF were performed. According to results of pathological examination, the 78 patients were divided into effective chemotherapy group (n=54) and ineffective chemotherapy group (n=24). ADC values, levels of serum ALP and TSGF, change rates of ADC values and levels of serum ALP and TSGF were compared between the two groups. The value of ADC value combined with serum ALP and TSGF in evaluating curative effect of neoadjuvant chemotherapy for osteosarcoma was analyzed with receiver operating characteristic curve (ROC). Results: After chemotherapy, ADC value in effective chemotherapy group increased significantly, while levels of serum ALP and TSGF decreased significantly (t=7.269, 18.778, 23.237, all P<0.05). Only after surgery, ADC value, levels of serum ALP and TSGF increased or decreased significantly in ineffective chemotherapy group (t=7.316, 15.083, 20.930, all P<0.05). Before and after chemotherapy, change rates of ADC values and levels of serum ALP and TSGF in effective chemotherapy group were all significantly higher than those in ineffective chemotherapy group (t=7.604, 5.482, 5.048, all P<0.05). ROC curve analysis showed that area under the curve (AUC) of ADC value combined with serum ALP and TSGF for evaluating curative effect of neoadjuvant chemotherapy was 0.912, which was higher than that of ADC value, ALP, TSGF, ADC value combined with ALP, ADC value combined with TSGF (0.847, 0.787, 0.701, 0.885, 0.876, respectively). Conclusion: ADC value combined with serum tumor markers ALP and TSGF is reliable in evaluating curative effect of neoadjuvant chemotherapy for osteosarcoma.