作　　者： (閤谦）; (吴骋）; (童林军）; (施一平）; (唐德伟）; (沈淳风）; (万良荣）; (徐波）; (黄钢）; (刘建军）;

机构地区： 上海交通大学医学院附属仁济医院核医学科,200127

出　　处： 《中华核医学与分子影像杂志》 2017年第9期559-563,共5页

摘　　要： 目的比较4种评价标准（RECIST1.1、PERCIST1.0、EORTC、WHO）在结直肠癌肝脏转移瘤患者新辅助化疗中的疗效评估价值。方法回顾性分析2010年1月至2013年9月间的41例结直肠癌伴肝脏转移瘤的患者资料，其中男27例（平均年龄68.48岁），女14例（平均年龄62.43岁）。所有患者均于新辅助化疗前及化疗4～6个周期后行2次18F－FDG PET/CT检查，用PERCIST1.0、RECIST1.1、EORTC和WHO标准分别进行疗效评价，结果分CR、PR、SD、PD 4类。PET/CT用于代谢及解剖显像的共同评估，如有需要间隔1周之内的增强CT或MRI图像也会用于疗效评估。用Kappa检验评价各标准之间的一致性；用χ^2检验比较4种评价标准的治疗有效率（RR）和疾病控制率（DCR）间的差异。结果PERCIST1.0的RR和DCR分别为31.71%（13/41）和63.41%（26/41），EORTC的RR和DCR分别为31.71%（13/41）与60.98%（25/41）。RECIST1.1的RR和DCR分别为17.07%（7/41）和68.29%（28/41），RECIST1.1和PERCIST1.0及EORTC结果一致性（κ值）分别为0.711和0.689。RECIST1.1与PERCIST1.0的DCR差异无统计学意义（χ^2＝2.000, P〉0.05），RR差异有统计学意义（χ^2＝6.000, P〈0.05）。EORTC与RECIST1.1的DCR差异无统计学意义（χ^2＝3.000, P〉0.05），RR差异有统计学意义（χ^2＝6.000, P〈0.05）。WHO标准的RR和DCR分别为12.20%（5/41）和70.73%（29/41），和PERCIST1.0标准的结果一致性好（κ＝0.629），两标准间RR差异有统计学意义（χ^2＝8.000，P〈0.05），DCR差异无统计学意义（χ^2＝3.000, P〉0.05）。结论解剖显像与代谢显像在评价结直肠癌肝脏转移瘤的疗效上具有很好的一致性，但代谢显像评价标准对RR的评价更敏感。 Objective To compare treatment response according to the PERCIST1.0, RECIST1.1, EORTC, and WHO criteria in patients with colorectal liver metastases （CLM） who received neoadjuvant chemotherapy. Methods A total of 41 CLM patients （27 males, average age 68.48 years; 14 females, average age 62.43 years） from January 2010 to September 2013 were included in this retrospective study. PET/CT scan was performed before chemotherapy and after 4-6 cycles＇ chemotherapy. The baseline and the sequential follow-up ^18F-FDG PET/CT of each patient were evaluated according to the PERCIST1.0, RECIST1.1, EORTC, and WHO criteria. The response was categorized into 4 levels including CR, PR, SD, PD. PET/ CT images were used for both metabolic and anatomic evaluation. The concurrent diagnostic CT or MRI images （ performed within 1 week of PET/CT） were also utilized when needed. The agreements of criteria were analyzed using Kappa test. The response rate （RR） and disease control rate （DCR） were compared using Х^2 test. Results The RR and DCR according to the PERCIST1.0, EORTC and RECIST1.1 criteria were 31.71% （ 13/41 ） and 63.41% （ 26/41 ）, 31.71% （ 13/41 ） and 60.98% （ 25/41 ）, 17.07% （ 7/41 ） and 68.29% （28/41）, respectively. The general comparison of PERCIST1.0 and RECIST1.1, EORTC and RECIST1.1 criteria showed good agreements （κ values： 0.711, 0.689）. Significant difference was not found in the DCR （Х^2=2.000, P〉0.05） but found in the RR（Х^2 = 6.000, P〈0.05） between PERCIST1.0 and RECIST1.1. Difference of DCR between EORTC and RECISTI.1 was not significant （Х^2 = 3.000, P〉0. 05）, while the RR had significant difference （Х^2 = 6.000, P〈0.05）. The RR and DCR according to WHO criterion were 12. 20% （5/41） and 70.73% （29/41） , which had a good consistency with those according to PERCIST1.0 criteria （κ= 0.629）. Significant statistical difference was not found in the DCR（Х^2= 3. 000, P〉0.05） but found in the RR（Х^2=8.000, P〈0.05） b

关 键 词： 结直肠肿瘤 肿瘤转移 肝 肿瘤辅助疗法 正电子发射断层显像术 体层摄影术 线计算机 脱氧葡萄糖