世界卫生组织（WHO）、实体瘤疗效评价标准（RECIST）1.1版、欧洲癌症研究与治疗组织（EORTC）及正电子发射断层显像术评价标准（PERCIST）在恶性实体瘤治疗反应评估中的比较
Comparison of WHO, RECIST 1.1, EORTC, and PERCIST criteria in the evaluation of treatment response in malignant solid tumors.
作者信息
Aras Mustafa, Erdil Tanju Y, Dane Faysal, Gungor Serkan, Ones Tunc, Dede Fuat, Inanir Sabahat, Turoglu Halil T
机构信息
aDepartment of Nuclear Medicine, Bulent Ecevit University School of Medicine, Zonguldak Departments of bNuclear Medicine cMedical Oncology, Marmara University School of Medicine, Istanbul dDepartment of Nuclear Medicine, Recep Tayyip Erdogan University School of Medicine, Rize, Turkey.
出版信息
Nucl Med Commun. 2016 Jan;37(1):9-15. doi: 10.1097/MNM.0000000000000401.
AIM
To compare response assessment according to the WHO, RECIST 1.1, EORTC, and PERCIST criteria in patients diagnosed with malignant solid tumors and who had received cytotoxic chemotherapy to establish the strength of agreement between each criterion.
MATERIALS AND METHODS
Sixty patients with malignant solid tumors were included in this retrospective study. The baseline and the sequential follow-up fluorine-18-fluorodeoxyglucose PET/computed tomography (CT) of each patient were evaluated according to the WHO, RECIST 1.1, EORTC, and PERCIST criteria. PET/CT images were used for both metabolic and anatomic evaluation. The concurrent diagnostic CT and MRI images (performed within 1 week of PET/CT) were also utilized when needed. The results were compared using the κ-statistics.
RESULTS
The response and progression rates according to the WHO criteria were 37 and 38%, respectively. The same ratios were also found for RECIST 1.1 (κ=1). The response and progression rates according to the EORTC criteria were 47 and 40%, respectively. When PERCIST criteria were used, one patient with progressive disease was upgraded to stable disease (κ=0.976). As we found the same results with WHO and RECIST 1.1 criteria, we used WHO criteria to compare the anatomic and metabolic criteria. When we compared the WHO and EORTC criteria, there was an agreement in 80% of the patients (κ=0.711). With WHO and PERCIST criteria, there was an agreement in 81.6% of the patients (κ=0.736).
CONCLUSION
Significant agreement was detected when the WHO, RECIST 1.1, EORTC, and PERCIST criteria were compared both within as well as between each other.
目的
比较世界卫生组织（WHO）、实体瘤疗效评价标准（RECIST）1.1版、欧洲癌症研究与治疗组织（EORTC）及正电子发射断层显像-容积成像标准（PERCIST）对诊断为恶性实体瘤且接受细胞毒性化疗患者的疗效评估，以确定各标准之间的一致性强度。
材料与方法
本回顾性研究纳入60例恶性实体瘤患者。根据WHO、RECIST 1.1、EORTC及PERCIST标准对每位患者的基线及序贯随访氟-18-氟脱氧葡萄糖正电子发射断层显像/计算机断层扫描（PET/CT）进行评估。PET/CT图像用于代谢和解剖学评估。必要时也使用同期诊断性CT和MRI图像（在PET/CT检查1周内进行）。使用κ统计量比较结果。
结果
根据WHO标准，缓解率和进展率分别为37%和38%。RECIST 1.1标准的缓解率和进展率与之相同（κ=1）。根据EORTC标准，缓解率和进展率分别为47%和40%。使用PERCIST标准时，1例疾病进展患者被升级为疾病稳定（κ=0.976）。由于我们发现WHO和RECIST 1.1标准结果相同，因此使用WHO标准比较解剖学和代谢标准。当我们比较WHO和EORTC标准时，80%的患者结果一致（κ=0.711）。使用WHO和PERCIST标准时，81.6%的患者结果一致（κ=0.736）。
结论
比较WHO、RECIST 1.1、EORTC及PERCIST标准时，在各标准内部以及相互之间均检测到显著一致性。
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