实体瘤WHO疗效标准与对数杀灭定量评价的探讨

The correlation of WHO criteria with the log cell kill quantitative determine

目的:临床以WHO标准评价疗效,尚无肿瘤细胞对数杀灭疗效评价及“治愈性”化疗研究报告。本研究目的是探讨WHO疗效标准与肿瘤体积或细胞负荷及细胞对数杀灭(logcellkill,LCK或LK)相互关系及提出细胞对数杀灭定量评价方法的必要性。方法:肿瘤体积下降比例即肿瘤细胞杀灭比例(killfraction,KF)据1SF计算,存活比例(survivingfraction,SF)据治疗后肿瘤体积除以治疗前体积测定,肿瘤细胞杀灭对数即为存活比例对数负数(LCK=-logSF)。结果:每级别WHO疗效在相同或不同大小肿瘤都存在体积、细胞负荷和LCK的显著差异,WHO疗效评价与LCK相互换算关系得到确定。结论:WHO标准不能定量评价肿瘤体积、细胞对数和LCK,提出可与WHO疗效评价相互换算的LCK定量评价方法非常必要。

Objective：WHO criteria has been used to tumor response evaluation, however, the tumor cell log kill（LCK） and “curative” chemotherapy studies were not be reported in clinical research. The objective of this study was to investigate the correlation of WHO criteria with the tumor volume, the tumor cell load and the LCK;and the necessity developing a method to measure LCK quantitatively. Methods：The rate of decreased tumor volume or tumor cell kill fraction （KF） was calculated by 1-SF and the surviving cell fraction （SF） may be measured by dividing the post-treated tumor volume by the prior-treated tumor volume, and the LCK was determined as the negatived log of SF（ LCK = - log SF）. Results：The tumor volume and cell load were all differential significantly in each gade of WHO response. The relation between the WHO criteria and the LCK has been defined. Conclusion： WHO response criteria can not determine the tumor volume, the cell load as well as the LCK. A new method evaluating LCK quantitatively has been proposed and it may be intereonverted with WHO response criteria.