中华消化外科杂志
中華消化外科雜誌
중화소화외과잡지
CHINESE JOURNAL OF DIGESTIVE SURGERY
2015年
6期
479-483
,共5页
孙轶群%童彤%章真%蔡三军%顾雅佳
孫軼群%童彤%章真%蔡三軍%顧雅佳
손질군%동동%장진%채삼군%고아가
直肠肿瘤,T3期%新辅助放化疗%磁共振成像%预测
直腸腫瘤,T3期%新輔助放化療%磁共振成像%預測
직장종류,T3기%신보조방화료%자공진성상%예측
Rectal neoplasms,T3 staging%Neoadjuvant chemoradiation therapy%Magnetic resonance imaging%Prediction
目的 探讨高分辨率MRI检查预测T3期直肠癌新辅助治疗效果的可行性.方法 回顾性分析2010-2012年复旦大学附属肿瘤医院收治的108例T3期直肠癌患者的临床资料,治疗前高分辨率MRI检查图像评估内容包括肿瘤TNM分期、肿瘤浸润直肠系膜深度(mrT3亚分期)、直肠系膜筋膜是否受累、肿瘤直径及肿瘤下缘距肛缘距离.患者新辅助治疗后均予手术切除病灶.分别采用术后病理学再分期及肿瘤退缩评分系统评估病灶对新辅助治疗的效果.多分类等级资料采用单因素分析,多因素分析采用Logistic回归分析.结果 新辅助治疗后,T3a、b、c期患者疗效好者比例分别为61.5％(16/26)、36.9％(24/65)、11.8％(2/17).病理学再分期单因素分析结果表明:T3亚分期,N分期及肿瘤直径是影响新辅助治疗效果的可能因素(x2=50.474,30.985,8.318,P＜0.05).病理学再分期多因素分析结果发现:T3b期是影响新辅助治疗效果的独立危险因素(OR =4.473,95％可信区间:2.003～9.991,P＜0.05).而以肿瘤退缩评分系统(TRG)作评估新辅助治疗效果的方式时,T3亚分期、N分期、直肠系膜筋膜受累情况、肿瘤直径和肿瘤下缘距肛缘距离与新辅助治疗效果无明确相关性(x2=6.264,6.159,2.949,2.189,6.335,P＞0.05).结论 新辅助治疗前高分辨率MRI检查显示的T3亚分期能够预测直肠癌对新辅助治疗的效果.
目的 探討高分辨率MRI檢查預測T3期直腸癌新輔助治療效果的可行性.方法 迴顧性分析2010-2012年複旦大學附屬腫瘤醫院收治的108例T3期直腸癌患者的臨床資料,治療前高分辨率MRI檢查圖像評估內容包括腫瘤TNM分期、腫瘤浸潤直腸繫膜深度(mrT3亞分期)、直腸繫膜觔膜是否受纍、腫瘤直徑及腫瘤下緣距肛緣距離.患者新輔助治療後均予手術切除病竈.分彆採用術後病理學再分期及腫瘤退縮評分繫統評估病竈對新輔助治療的效果.多分類等級資料採用單因素分析,多因素分析採用Logistic迴歸分析.結果 新輔助治療後,T3a、b、c期患者療效好者比例分彆為61.5％(16/26)、36.9％(24/65)、11.8％(2/17).病理學再分期單因素分析結果錶明:T3亞分期,N分期及腫瘤直徑是影響新輔助治療效果的可能因素(x2=50.474,30.985,8.318,P＜0.05).病理學再分期多因素分析結果髮現:T3b期是影響新輔助治療效果的獨立危險因素(OR =4.473,95％可信區間:2.003～9.991,P＜0.05).而以腫瘤退縮評分繫統(TRG)作評估新輔助治療效果的方式時,T3亞分期、N分期、直腸繫膜觔膜受纍情況、腫瘤直徑和腫瘤下緣距肛緣距離與新輔助治療效果無明確相關性(x2=6.264,6.159,2.949,2.189,6.335,P＞0.05).結論 新輔助治療前高分辨率MRI檢查顯示的T3亞分期能夠預測直腸癌對新輔助治療的效果.
목적 탐토고분변솔MRI검사예측T3기직장암신보조치료효과적가행성.방법 회고성분석2010-2012년복단대학부속종류의원수치적108례T3기직장암환자적림상자료,치료전고분변솔MRI검사도상평고내용포괄종류TNM분기、종류침윤직장계막심도(mrT3아분기)、직장계막근막시부수루、종류직경급종류하연거항연거리.환자신보조치료후균여수술절제병조.분별채용술후병이학재분기급종류퇴축평분계통평고병조대신보조치료적효과.다분류등급자료채용단인소분석,다인소분석채용Logistic회귀분석.결과 신보조치료후,T3a、b、c기환자료효호자비례분별위61.5％(16/26)、36.9％(24/65)、11.8％(2/17).병이학재분기단인소분석결과표명:T3아분기,N분기급종류직경시영향신보조치료효과적가능인소(x2=50.474,30.985,8.318,P＜0.05).병이학재분기다인소분석결과발현:T3b기시영향신보조치료효과적독립위험인소(OR =4.473,95％가신구간:2.003～9.991,P＜0.05).이이종류퇴축평분계통(TRG)작평고신보조치료효과적방식시,T3아분기、N분기、직장계막근막수루정황、종류직경화종류하연거항연거리여신보조치료효과무명학상관성(x2=6.264,6.159,2.949,2.189,6.335,P＞0.05).결론 신보조치료전고분변솔MRI검사현시적T3아분기능구예측직장암대신보조치료적효과.
Objective To explore the efficacy of high-resolution MRI in the prediction of tumor complete response after neoadjuvant chemoradiation therapy for T3 rectal cancer.Methods The clinical data of 108 patients with T3 rectal cancer who were admitted to Shanghai Cancer Center of Fudan University from 2010 to 2012 were retrospectively analyzed.The TNM stage of tumor,extramural depth of tumor invasion (mrT3 stage),involvement of mesorectum and rectal fascia,tumor diameter and distance from anal edge to lower edge of tumor were the main items of evaluation using the high-resolution MRI.A total of 108 patients underwent surgical resection of tumor after neoadjuvant chemoradiation therapy.The tumor complete response after neoadjuvant chemoradiation therapy was evaluated by tumor node metastasis (TNM) stage and tumor regression grade (TRG).The categorical data and multivariate analysis were done by the single factor analysis of variance (ANOVA) and Logistic regression analysis.Results The positive response rate of the T3a,T3b and T3c in the patients were 61.5％ (16/26),36.9％ (24/65) and 11.8％ (2/17) after neoadjuvant chemoradiation therapy,respectively.The mrT3,mrN and tumor diameter were the potential factors affecting response of neoadjuvant chemoradiation therapy by the univariate analysis of pathological restaging (x2 =50.474,30.985,8.318,P ＜ 0.05).The mrT3 was an independent risk factor affecting response of neoadjuvant chemoradiation therapy by the multivariate analysis of pathological restaging (OR =4.473,95 ％ confidence interval:2.003-9.991,P ＜ 0.05).There was no significant difference between the mrT3 stage,N stage,involvement of mesorectum and rectal fascia,tumor diameter and distance from anal edge to lower edge of tumor before therapy and the response after neoadjuvant chemoradiation therapy based on the tumor regression grade(TRG) (x2 =6.264,6.159,2.949,2.189,6.335,P ＞ 0.05).Conclusion The mrT3 in patients undergoing high-resolution MRI before neoadjuvant chemoradiation therapy could predict the tumor complete response after neoadjuvant chemoradiation therapy for T3 rectal cancer.
