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目的比较mRECIST和RECIST评价标准,为肝癌经肝动脉化疗栓塞(TACE)疗效评价选择更为合适的CT应用方法。方法对62例原发性肝癌TACE后,采用mRECIST标准和RECIST标准分别进行对比研究。TACE前、后CT检查均采用三期扫描,强调动脉期强化的存活肿瘤的测量,根据mRECIST和RECIST评价标准分别评估缓解程度。两种方法评价缓解率的比较采用χ2检验。结果采用mRECIST标准评价肝癌TACE后完全缓解(CR)为8例、部分缓解(PR)为28例、稳定(SD)为14例、进展(PD)为12例,缓解率为58.1%;采用RECIST标准评价的CR为0例、PR为14例、SD为37例、PD为11例,缓解率为22.6%,经χ2检验,P<0.01,二者有显著性差异。结论采用mRECIST标准对原发性肝癌TACE作疗效评价,特别是强调治疗后动脉期强化的存活肿瘤的测量,能客观反映肿瘤的退缩和缓解率,对决定后续治疗很有帮助。
Objective To compare the evaluation criteria of mRECIST and RECIST in order to choose a more appropriate CT application for the evaluation of therapeutic effect of transcatheter arterial chemoembolization (TACE) for liver cancer. Methods After TACE of 62 cases of primary hepatocellular carcinoma, the mRECIST and RECIST criteria were compared respectively. Three-phase CT scans were performed before and after TACE, emphasizing the measurement of enhanced survival in the arterial phase and assessing the degree of remission according to the mRECIST and RECIST criteria, respectively. Two methods to evaluate the remission rate comparison using χ2 test. Results The complete remission (CR) of TACE after liver cancer was evaluated by mRECIST. The CR was 28, the partial response (PR) was 28, the stable (SD) was 14 and the progression (PD) was 12. The response rate was 58.1% Criteria for the evaluation of CR was 0 cases, PR was 14 cases, SD was 37 cases, PD was 11 cases, the response rate was 22.6%, by χ2 test, P <0.01, both significant differences. Conclusions The mRECIST standard is used to evaluate the therapeutic effect of TACE on primary hepatocellular carcinoma. In particular, the emphasis on the measurement of survival-enhanced tumors during arterial phase after treatment can objectively reflect the tumor regression and remission rate, which is helpful for the decision of follow-up treatment.