CAJ | 학술논문

目的比较实体瘤反应评价标准(RECIST)、欧洲肝病学会(EASL)和改良的RECIST标准用于评价原发性肝癌化疗栓塞术后肿瘤缓解程度的一致性.方法 50例确诊为原发性肝癌患者接受两次化疗栓塞术.术前1周内、治疗后4周患者分别接受螺旋CT或MR三期扫描.据RECIST、EASL、改良RECIST标准评价肿瘤缓解程度.3种方法评价缓解率的比较采用x2检验,一致性检验采用kappa分析.结果据RECIST、EASL、改良RECIST标准分别评价疗效时,达CR、PR、SD、PD患者例数分别为0、10、30、10例,6、21、14、9例,6、21、13、10例.据上述3种标准评价治疗的缓解率分别为20%、54%、54%,差异有统计学意义(P＜0.01).RECIST与EASL标准之间、RECIST与改良RECIST标准之间的kappa分析,kappa值分别为0.382、0.170(P=0.000);而EASL与改良RECIST标准之间的kappa值达0.857(P=0.000).结论 RECIST标准低估原发性肝癌化疗栓塞术局部治疗的效果.EASL和改良RECIST标准,对疗效评价一致性程度高;但改良RECIST标准在临床实践中更简便易行.
목적 비교실체류반응평개표준(RECIST)、구주간병학회(EASL)화개량적RECIST표준용우평개원발성간암화료전새술후종류완해정도적일치성.방법 50례학진위원발성간암환자접수량차화료전새술.술전1주내、치료후4주환자분별접수라선CT혹MR삼기소묘.거RECIST、EASL、개량RECIST표준평개종류완해정도.3충방법평개완해솔적비교채용x2검험,일치성검험채용kappa분석.결과 거RECIST、EASL、개량RECIST표준분별평개료효시,체CR、PR、SD、PD환자례수분별위0、10、30、10례,6、21、14、9례,6、21、13、10례.거상술3충표준평개치료적완해솔분별위20%、54%、54%,차이유통계학의의(P＜0.01).RECIST여EASL표준지간、RECIST여개량RECIST표준지간적kappa분석,kappa치분별위0.382、0.170(P=0.000);이EASL여개량RECIST표준지간적kappa치체0.857(P=0.000).결론 RECIST표준저고원발성간암화료전새술국부치료적효과.EASL화개량RECIST표준,대료효평개일치성정도고;단개량RECIST표준재림상실천중경간편역행.
Objective To compare the concordance among RECIST, EASL and modified RECIST criteria for the evaluation of tumor response after transarterial chemoembolization of primary liver cancer.Methods Fifty patients with primary liver cancer underwent 2 TACE cycles separated by 30-40 days.Triphasic helical CT or MRI scans were performed at baseline, at 4 weeks after TACE procedure, and 2 independent radiologists evaluated tumor response according to above-mentioned three different criteria. Chisquare test was used to compare the response rate, and kappa coefficients were used to evaluate the coherence. Results When tumor responses were evaluated using the RECIST-EASL and modified RECIST criteria, the numbers of the patients achieved complete response, partial response, stable disease,progressive disease were 0, 10, 30, 10; 6,21,14,9; 6,21,13,10 respectively. The objective response rates for three different criteria were 20%, 54%, 54% respectively ( P ＜ 0. 01 ). Kappa coefficients between RECIST and EASL, between RECIST and modified RECIST, between EASL and modified RECIST were 0. 382, 0. 170, and 0. 857 (P = 0. 000). Conclusions RECIST criteria underestimates the extent of tumor response after TACE in primary liver cancer. Both EASL and modified RECIST criteria appear to agree with each other in determining treatment response. Furthermore, the modified RECIST is more convenient in clinical practice compared with EASL criteria.