Kim Mi Na, Kim Beom Kyung, Han Kwang-Hyub, Kim Seung Up
Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea.
Expert Rev Gastroenterol Hepatol. 2015 Mar;9(3):335-48. doi: 10.1586/17474124.2015.959929. Epub 2014 Nov 5.
Radiological response assessment criteria in hepatocellular carcinoma (HCC) have evolved to accurately evaluate tumor responses. The WHO criteria and the subsequent Response Evaluation Criteria in Solid Tumors (RECIST) evaluate change in tumor size; however, these criteria generally ignore tumor necrosis and therefore may underestimate treatment responses. Thus, a panel of experts of the European Association for the Study of Liver (EASL) amended the response criteria to take into account tumor necrosis. In 2010, the modified RECIST (mRECIST) was developed, which consider both the concept of tumor viability based on arterial enhancement and single linear summation, ultimately simplifying EASL criteria. Currently, the mRECIST represents the gold standard for radiologically evaluating tumor response during HCC treatment. Here, the authors review application and performance of mRECIST as well as other HCC response assessment criteria and discuss unmet and open issues regarding response evaluation for HCC treatments.
肝细胞癌（HCC）的放射学反应评估标准已经发展到能够准确评估肿瘤反应。世界卫生组织（WHO）标准以及随后的实体瘤疗效评价标准（RECIST）评估肿瘤大小的变化；然而，这些标准通常忽略肿瘤坏死，因此可能低估治疗反应。因此，欧洲肝脏研究协会（EASL）的一个专家小组修订了反应标准以考虑肿瘤坏死情况。2010年，改良RECIST（mRECIST）被制定出来，它基于动脉期强化和单一径线总和来考虑肿瘤活性的概念，最终简化了EASL标准。目前，mRECIST是放射学评估HCC治疗期间肿瘤反应的金标准。在此，作者回顾了mRECIST以及其他HCC反应评估标准的应用和性能，并讨论了HCC治疗反应评估中未满足和待解决的问题。
