摘要
目的观察术前高分辨率MRI评估新辅助治疗用于T3期直肠癌效果的价值。方法165例T3期直肠癌患者于新辅助治疗前接受高分辨率MR检查,观察直肠系膜受累情况、肿瘤下缘距肛缘距离、肿瘤直径,评估T分期、N分期;之后手术切除肿瘤,术后以结直肠癌TNM分期标准行病理学再分期及肿瘤退缩评分(TRG),系统评估新辅助治疗效果。采用单因素及多因素Logistic回归分析观察新辅助治疗效果的影响因素。结果新辅助治疗后,根据TNM分期评价标准,63例疗效好,102例效果差。单因素分析结果显示,治疗效果的影响因素包括患者年龄和肿瘤N分期、T3亚分期及肿瘤直径(P均<0.05);多因素分析结果显示,患者年龄及肿瘤T3亚分期、肿瘤直径是TNM分期评估疗效的独立影响因素(P均<0.05)。以TRG系统评估新辅助治疗效果,患者年龄、肿瘤标记物及肿瘤T3亚分期、N分期、肿瘤直径、直肠系膜受累情况等均与之无明显相关(P均>0.05)。结论高分辨率MRI可用于术前预测T3期直肠癌患者接受新辅助治疗的效果。
Objective To observe the value of preoperative high resolution MRI in evaluation on efficacy of neoadjuvant therapy for T3 rectal cancer.Methods Totally 165 patients with stage T3 rectal cancer received neoadjuvant therapy followed by surgical resection of the tumor.The patient underwent high-resolution MR examination before neoadjuvant therapy.The involvement of the mesentery,the distance between lower margin of tumor and anal margin,the diameter of tumor,and T stage and N stage were evaluated.Then the patients received neoadjuvant therapy followed by surgical resection of the tumor.After surgical resection of tumor,pathological restaging was performed according to TNM staging criteria of colorectal cancer and of tumor regression grading(TRG)to evaluate the efficacy of neoadjuvant therapy,respectively.Univariate and multivariate Logistic regression analysis was used to observe the factors affecting efficacy of neoadjuvant therapy.Results After neoadjuvant therapy,63 patients had good treatment effect,while 102 patient had poor treatment effect according to TNM staging criteria.Univariate analysis showed that the influencing factors of TNM staging evaluation of neoadjuvant therapy included patient age,tumor N stage,T3 substage and tumor diameter(all P<0.05).The results of multivariate analysis showed that the age of patients,tumor T3 substage and tumor diameter were independent factors affecting the efficacy assessed with TNM stage assessment(all P<0.05).When evaluating the efficacy of neoadjuvant therapy with TRG system,patients'age,tumor markers,tumor T3 substage,tumor N stage,tumor diameter,and mesenteric involvement were not correlated with the treatment effect(all P>0.05).Conclusion High-resolution MRI could be used to predict the efficacy of neoadjuvant therapy before surgeryical operation in patients with T3 rectal cancer.
作者
杜希剑
余开湖
章凯敏
DU Xijian;YU Kaihu;ZHANG Kaimin(Department of Medical Imaging, the First Affiliated Hospital of Hubei University of Science and Technology, Xianning Central Hospital, Xianning 437100, China)
出处
《中国介入影像与治疗学》
北大核心
2021年第9期548-552,共5页
Chinese Journal of Interventional Imaging and Therapy
关键词
结直肠肿瘤
磁共振成像
肿瘤分期
新辅助治疗
colorectal neoplasms
magnetic resonance imaging
neoplasm staging
neoadjuvant therapy