比较单径测量法与体积测量法评价晚期非小细胞肺癌化疗的疗效  

Comparison of uni-dimensional measurements and volumetric measurements on evaluation of treatment response for advancednon-small-cell lung cancer after chemotherapy

作　　者：许艺兰 张晓鹏[2] 齐丽萍[2] 孙应实[2] 陈颖[2] 李晓婷[2] 

机构地区：[1]北京清华长庚医院放射科,北京102218 [2]北京大学临床肿瘤学院北京肿瘤医院暨北京市肿瘤防治研究所医学影像科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国医学影像技术》2015年第3期401-404,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家重点基础研究发展计划(973计划)(2006CB705700)

摘　　要：目的比较单径测量法与体积测量法评估晚期非小细胞肺癌化疗疗效的一致性。方法回顾性分析104例接受化疗的晚期非小细胞肺癌患者化疗前及化疗2周期后的胸部增强CT扫描图像,对每例患者选取1-2个肺内病灶作为靶病灶,测量靶病灶的轴位最大长径、与其垂直的最大短径、冠状位垂直最大径及体积,根据轴位最大长径、体积的变化率分别进行疗效评价。记录每个病灶的形态学表现。结果 104例中,共85例（85/104,81.73%）采用体积测量与单径测量的评价结果一致、二者的评价呈中度一致（Kappa值为0.520）。单径测量评价为疾病稳定（SD）的85例患者中,评价结果一致组与不一致组间治疗前后形态变化、轴位垂直短径变化率、高度变化率的差异均有统计学意义（P均〈0.05）。结论在晚期非小细胞肺癌化疗疗效评估中,单径测量法与体积测量法的评价结果一致性为中度。Objective To explore the agreement in treatment response classifications between uni-dimensional and volumetric measurements for patients with advanced non-small-cell lung cancer after chemotherapy.Methods Totally 104 patients with non-small cell lung cancer underwent contrast-enhanced chest CT before and after two cycles of chemotherapy were analyzed retrospectively.One or two lesions were selected for each patient.For each lesion,the axial maximum diameter,largest perpendicular diameter,coronal largest diameter（height）and volume were measured before and after treatment.The response was classified by the reduction ratio of maximum diameter and volume.The shape of each lesion were recorded.Results There was an 81.73%（85/104）agreement rate in the response classification between the uni-dimensional measurements and volumetric measurements with a Kappavalue of 0.520 which corresponded to a moderate agreement.The obvious shape change,the percentage changes of axial largest perpendicular diameter and coronal largest diameter（height）had significant difference between the groups of agree and disagree in those 85 cases considered as stable disease following the uni-dimensional measurement（all P〈0.05）.Conclusion There is moderate agreement between volumetric measurements and unidimensional measurements on the evaluation of treatment response for advanced non-small-cell lung cancer after chemotherapy.

关 键 词：癌 非小细胞肺 单径测量法 体积测量法 疗效评估 

分 类 号：R814.42[医药卫生—影像医学与核医学] R734.2[医药卫生—放射医学]