局部进展期直肠癌新辅助放化疗后病理完全缓解临床预测因素的研究进展

Research progress in clinical predictors of pathological complete response in locally advanced rectal cancer after neoadjuvant radiochemotherapy

新辅助放化疗+全直肠系膜切除术已成为局部进展期直肠癌的标准治疗模式。但不同患者对于新辅助放化疗的敏感性差异较大,部分患者新辅助放化疗后可获得病理完全缓解,远期生存明显改善,部分患者肿瘤继续进展,因此准确预测新辅助放化疗后能否获得病理完全缓解对于指导患者的个体化治疗至关重要。现有研究已经表明,年龄、肿瘤病理类型、TNM分期、肿瘤占肠腔环周比例、肿瘤下缘距离肛缘的距离、癌胚抗原水平、中性粒细胞与淋巴细胞比等一些容易获得的临床指标对预测新辅助放化疗后能否获得病理完全缓解有一定价值。本文主要对局部进展期直肠癌新辅助放化疗后能否获得病理完全缓解的临床预测因素研究进展作一综述。

Neoadjuvant chemoradiotherapy(nCRT)+total mesorectal excision(TME)has become the standard mode of treatment for locally advanced rectal cancer(LARC).However,the sensitivity of different patients to nCRT varies greatly,some patients can get pathological complete response(pCR),and their long-term survival is significantly improved,Some patients'tumors continue to progress,therefore,accurate prediction of whether pCR can be achieved after nCRT is very important for guiding individualized treatment of patients.Current studies have shown that some accessible clinical factors,such as age,pathological types of tumors,TNM staging,circumferential extent of tumor,distance to the anal verge,CEA level,neutrophil lymphocyte ratio,can be used to predict whether pCR can be achieved.This article reviews the progress of clinical predictors of pCR in LARC after nCRT.