对比分析PERCIST1.0和RECIST1.1标准评价中晚期宫颈癌同步放化疗的治疗反应的初步研究#br#

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摘要目的：应用18F-FDG代谢PERCIST1.0及解剖学RECIST1.1两种标准评价宫颈癌同步放化疗（CCRT）治疗反应，对比分析两种标准评价结果的差异及治疗反应与血清鳞状细胞癌抗原（SCC-Ag）的相关性。方法：回顾性分析2011年10月—2016年2月间多中心病理证实原发宫颈鳞癌患者共22例，FIGO分期ⅡB～Ⅳ期，分别于治疗前后行两次18F-FDG PET/CT扫描，应用PETCIST1.0及RECIST1.1标准评价治疗效果。同时观察不同治疗反应组患者治疗前、后的血清SCC-Ag变化水平。结果：PERCIST1.0标准评价结果：CMR 3例、PMR 9例、SMD 7例及PMD 3例；RECIST1.1标准评价结果：CR 0例、PR 11例、SD 7例及PD 4例。两种标准评价结果之间存在明显差异（χ2=16.76，P=0.01），Kappa值为0.321（P=0.018），其中10/22（45.45%）例患者两种标准评价结果不一致。PERCIST1.0和RECIST1.1标准评价治疗有效率（CMR/CR+PMR/PR）分别为：54.55%（12/22）和50%（11/22），其中PERCIST1.0评价为2例CMR、6例PMR及3例SMD，而RECIST1.1全部评价为PR；同时，RECIST1.1评价7例SD，而PERCIST1.0评价为1例CMR、3例PMR及3例SMD。治疗后不同治疗反应组患者SCC-Ag水平存在明显差异（F=7.08，P=0.002），且两者之间存在明显正相关（γ=0.529，P=0.011）。有效组（CMR+PMR）治疗前、后SCC-Ag存在明显差异（T=2.28，P=0.044）；而无效组（SMD+PMD）治疗前、后SCC-Ag明显不显著（T=-0.42，P=0.687）。结论：PERCIST1.0和RECIST1.1两种标准对宫颈癌CCRT治疗反应的评价结果存在明显差异。PERCIST1.0标准更能准确评价宫颈癌CCRT的不同治疗反应。

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	徐微娜1
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关键词 ：宫颈肿瘤, 正电子发射断层显像术

Abstract：Objective: To compare 18F-FDG metabolism with morphologic criteria for evaluating concurrent chemoradiotherapy(CCRT) response of cervical cancer, and to analyze to relationship between treatment response and serum squamous cell carcinoma antigen(SCC-Ag) levels. Methods: From October 2011 to February 2016, twenty-two patients with primary advanced cervical cancer confirmed by pathology were enrolled in this retrospective study, with FIGO stage ⅡB～Ⅳ. 18F-FDG PET/CT was performed before and after CCRT and therapeutic response evaluation was performed according to both PERCIST1.0 and RECIST1.1. Pre- and post-treatment SCC-Ag levels were observed. Results: In PERCIST1.0 analysis, 3 cases had CMR, 9 cases had PMR, 7 cases had SMD, and 3 cases had PMD. In RECIST1.1 analysis, 11 cases had PR, 7 cases had SD, 4 cases had PD and no patient had CR. There was significant difference in response classification between the two criteria(χ2=16.76, P=0.01). There was 45.45%(10/22) disagreement found with a fair agreement(P=0.018). The therapeutic response rates(CMR/CR+PMR/PR) were 54.55%(12/22) and 50%(11/22), respectively. Of the 11 patients with PR by RECIST1.1 were classified to 2 CMR, 6 PMR and 3 SMD by PERCIST1.0. At same time, of the 7 cases with SD by RECIST1.1 were classified to 1 CMR, 3 PMR and 3 SMD by PERCIST1.0. The post-treatment SCC-Ag levels of different therapeutic response groups were significantly different(F=7.08, P=0.002), and there was positive correlated between them(γ=0.529, P=0.011). There was a significant difference between pre- and post-treatment SCC-Ag levels for therapeutic response group(T=2.28, P=0.044), while there was no significantly different for therapy no-response group(T=-0.42, P=0.687). Conclusion: Disagreement was found in CCRT therapeutic response of cervical cancer evaluation and PERCIST1.0 may be more accurately distinguish to therapeutic response.

Key words： Cervix neoplasms Positron-emission tomography

收稿日期: 2017-01-10

PACS:	Ｒ737.33
	Ｒ817.4

通讯作者: 辛军，中国医科大学附属盛京医院放射科，110004。E-mail：xinj@vip.sina.com.cn

作者简介: 徐微娜（１９73－），女，辽宁辽中人，副教授。E-mail：xuwn@sj-hospital.org

引用本文:

徐微娜1，于丽娟2，杨之光1，辛军1. 对比分析PERCIST1.0和RECIST1.1标准评价中晚期宫颈癌同步放化疗的治疗反应的初步研究#br#[J]. 中国临床医学影像杂志, 2017, 28(10): 747-751.
XU Wei-na1, YU Li-juan2, YANG Zhi-guang1, XIN Jun1. Comparison of PERCIST1.0 and RECIST1.1 for the evaluation of #br# concurrent chemoradiotherapy response in advanced cervical cancer. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(10): 747-751.

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http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2017/V28/I10/747

[1]Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009[J]. CA Cancer J Clin, 2009, 59(4): 225-249.
[2]Monk BJ, Tewari KS, Koh WJ. Multimodality therapy for locally advanced cervical carcinoma: state of the art and future directions[J]. J Clin Oncol, 2007, 25(20): 2952-2965.
[3]Juweid ME, Cheson BD. Positron-emission tomography and assessment of cancer therapy[J]. N Engl J Med, 2006, 354(5): 496-507.
[4]Wahl RL, Jacene H, Kasamon Y, et al. From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors[J]. J Nucl Med, 2009, 50(Suppl): 122S-150S.
[5]Murakami A, Nakagawa T, Fukushima C, et al. Relationship between decreased expression of squamous cell carcinoma antigen 2 and E-cadherin in primary cervical cancer lesions and lymph node metastasis[J]. Oncol Rep, 2008, 19(1): 99-104.
[6]Ohno T, Nakayama Y, Nakamoto S. Measurement of serum squamouse cell carcinoma antigen levels as a predictor of radiation response in patients with carcinoma of the uterine cervix[J]. Cancer, 2003, 97(12): 3114-3120.
[7]Moule RN, Kayani L, Prior T, et al. Adaptive 18Fluoro-2-deoxyglucose Positron Emission Tomography/Computed Tomography-based Target Volume Delineation in Radiotherapy Planning of Head and Neck Cancer[J]. Clin Oncol, 2011, 23(5): 364-371.
[8]Eisenhauer EA, Thearasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline(version1.1)[J]. Eur J Cancer, 2009, 45(2): 228-247.
[9]李亚明. 功能影像与肿瘤化疗疗效评价[J]. 中国实用内科杂志，2012，32（4）：243-244.
[10]Weber WA. Assessing tumor response to therapy[J]. J Nucl Med, 2009, 50(Suppl): 1s-10s.
[11]Min SJ, Jang HJ, Kim JH. Comparison of the RECIST and PERCIST criteria in solid tumors: a pooled analysis and review[J]. Oncotarget, 2016, 7(19): 27848-27854.
[12]Ding Q, Cheng X, Yang L, et al. PET/CT evaluation of response to chemotherapy in non-small cell lung cancer: PET response criteria in solid tumors(PERCIST) versus response evaluation criteria in solid tumors(RECIST)[J]. J Thorac Dis, 2014, 6(6): 677-683.
[13]Yanagawa M, Tatsumi M, Miyata H, et al. Evaluation of response to neoadjuvant chemotherapy for esophageal cancer: PET response criteria in solid tumors versus response evaluation criteria in solid tumors[J]. J Nucl Med, 2012, 53(6): 872-880.
[14]Skougaard K, Nielsen D, Jensen BV, et al. Comparison of EORTC criteria and PERCIST for PET/CT response evaluation of patients with metastatic colorectal cancer treated with irinotecan and cetuximab[J]. J Nucl Med, 2013, 54(7): 1026-1031.
[15]Ordu C, Selcuk NA, Akosman C, et al. Comparison of metabolic and anatomic response to chemotherapy based on PERCIST and RECIST in patients with advanced stage non-small cell lung cancer[J]. Asian Pac J Cancer Prev, 2015, 16(1): 321-326.
[16]Hu YY, Fan W, Zhang X, et al. Complementary Roles of Squamous Cell Carcinoma Antigen and (18)F-FDG PET/CT in Suspected Recurrence of Cervical Squamous Cell Cancer[J]. J Cancer, 2015, 20, 6(3): 287-291.
[17]Olsen JR, Dehdashti F, Siegel BA, et al. Prognostic utility of squamous cell carcinoma antigen in carcinoma of the cervix: association with pre- and post-treatment FDG-PET[J]. Int J Radiat Oncol Biol Phys, 2011, 81(3): 772-777.
[18]Schwarz JK, Siegel BA, Dehdashti F, et al. Association of posttherapy positron emission tomography with tumor response and survival in cervical carcinoma[J]. JAMA, 2007, 298(19): 2289-2295.
[19]Bhoil A, Singh B, Singh N, et al. Can 3’-deoxy-3’-(18)F-fluorothymidine or 2’-deoxy-2’-(18)F-fluoro-d-glucose PET/CT better assess response after 3-weeks treatment by epidermal growth factor receptor kinase inhibitor, in non-small lung cancer patients? Preliminary results[J]. Hell J Nucl Med, 2014, 17(2): 90-96.
[20]Grigsby PW. PET/CT imaging to guide cervical cancer therapy[J]. Future Oncol, 2009, 5(7): 953-958.
[21]Beriwal S, Kannan N, Sukumvanich P, et al. Complete metabolic response after definitive radiation therapy for cervical cancer: patterns and factors predicting for recurrence[J]. Gynecol Oncol, 2012, 127(2): 303-306.
[22]Keys HM, Bundy BN, Stehman FB, et al. Radiation therapy with and without extrafascial hysterectomy for bulky stage IB cervical carcinoma: a randomized trial of the Gynecologic Oncology Group[J]. Gynecol Oncol, 2003, 89(3): 343-353.
[23]Fendler WP, Philippe Tiega DB, Llhan H, et al. Validation of several SUV-based parameters derived from 18F-FDG PET for prediction of survival after SIRT of hepatic metastases from colorectal cancer[J]. J Nucl Med, 2013, 54(8): 1202-1208.