CAJ | 학술논문

目的探讨64排多层螺旋CT(MSCT)和血清淀粉样蛋白A(SAA)联合术前评估进行直肠癌术前分期的准确性及其临床应用价值.方法前瞻性纳入2007年10月至2008年10月期间住院的225例直肠癌患者,将患者随机分为MSCT组和MSCT与SAA联合组,联合组术前行MSCT和SAA联合评估,MSCT组术前只行MSCT评估.分别将两组术前T、N、M、TNM分期准确度进行比较,并比较两组手术方案的预测符合率.结果本研究实际纳入病例225例,MSCT和SAA联合组110例,MSCT组115例,两组基线情况具有可比性.联合组术前T、N、M和TNM分期的准确度分别为87.3%、85.2%、100%和86.4%,MSCT组的准确度分别为85.2%、67.0%、100%和66.1%;两组术前N分期和TNM分期准确度差异具有统计学意义(P=0.009、0.001).两组手术方案的预测符合率分别为94.7%和81.7%,差异具有统计学意义(P=0.003).结论 MSCT和SAA联合评估的策略可以提高直肠癌患者术前分期N、TNM的准确性,并可提高预测手术方案的符合率.
목적 탐토64배다층라선CT(MSCT)화혈청정분양단백A(SAA)연합술전평고진행직장암술전분기적준학성급기림상응용개치.방법 전첨성납입2007년10월지2008년10월기간주원적225례직장암환자,장환자수궤분위MSCT조화MSCT여SAA연합조,연합조술전행MSCT화SAA연합평고,MSCT조술전지행MSCT평고.분별장량조술전T、N、M、TNM분기준학도진행비교,병비교량조수술방안적예측부합솔.결과 본연구실제납입병례225례,MSCT화SAA연합조110례,MSCT조115례,량조기선정황구유가비성.연합조술전T、N、M화TNM분기적준학도분별위87.3%、85.2%、100%화86.4%,MSCT조적준학도분별위85.2%、67.0%、100%화66.1%;량조술전N분기화TNM분기준학도차이구유통계학의의(P=0.009、0.001).량조수술방안적예측부합솔분별위94.7%화81.7%,차이구유통계학의의(P=0.003).결론 MSCT화SAA연합평고적책략가이제고직장암환자술전분기N、TNM적준학성,병가제고예측수술방안적부합솔.
Objective To determine the accuracy and clinical value of combining 64 multi-slice spiral computer tomography (MSCT) and serum amyloid A protein (SAA) in the preoperative staging of rectal cancer.Methods Prospectively enrolled patients with rectal cancer from October 2007 to October 2008.The patients were randomly assigned into two groups:MSCT and SAA combined group:both MSCT and SAA combinative assessment were performed for preoperative evaluation; MSCT group:only MSCT was performed preoperatively for tumor staging.The accuracy of the preoperative T,N,M,and TNM staging and the concordance rate of predictive operative strategy were compared between the two groups.Results Total of 225 cases with rectal cancer were enrolled in this study.There were 110 cases in MSCT and SAA combined group and 115 cases in MSCT group.The baseline characteristics was comparable between the two groups.For MSCT and SAA combined group,the accuracies of preoperative staging of T,N,M and TNM was 87.3%,85.2%,100% and 86.4%,respectively; and for MSCT group,the corresponding rates was 85.2%,67.0%,100% and 66.1%,respectively.Statistical differences was found in the accuracy of preoperative N and TNM staging between the two groups (P =0.009 and 0.001,respectively).In addition,there was statistical difference in the accuracy of prediction to operative procedures between the two groups (94.7% vs.81.7%,P=0.003).Conclusion Combinative assessment of MSCT and SAA could improve the accuracy of preoperative staging,and thus provide higher predictive coincidence rate of operative procedures.