Wiegering Armin, Kunz Meik, Hussein Mohamed, Klein Ingo, Wiegering Verena, Uthe Friedrich Wilhelm, Dietz Ulrich A, Jurowich Christian, Bley Thorsten, Dandekar Thomas, Germer Christoph-Thomas, Ritter Christian
Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany,
Int J Colorectal Dis. 2015 Aug;30(8):1067-73. doi: 10.1007/s00384-015-2265-z. Epub 2015 May 22.
Neoadjuvant therapy could improve oncological outcome of patients suffering from colon cancer. An accurate staging method is needed to define suitable patients. The aim of this retrospective study was to validate the value of CT for identifying patients with local advanced (T3/4) or nodal-positive colon cancer.
Preoperative abdominal CT scans of 210 patients with colon cancer were evaluated by two radiologists independently for the T stage and N stage. Results were compared to pathology. Patients were stratified according to the guidelines for rectal cancer into patients with low risk (T0/1/2 and N0) or high risk (T3/4 or N+).
Inter-observer correlation was high with over 90 %. Overall sensitivity T stage was 93.0 % and for N stage 76.9 %. Using CT scan to identify local advanced (T3/4 or N+) tumors, the consensus sensitivity was 94.9 %, the specificity 53.6 %, the positive predictive value (PPV) 92.8 %, and the negative predictive value (NPV) 62.5 %.
Computer tomography represents an effective tool for identifying patients with colon cancer suitable for neoadjuvant therapy according to the guidelines for rectal cancer.
新辅助治疗可改善结肠癌患者的肿瘤学结局。需要一种准确的分期方法来确定合适的患者。这项回顾性研究的目的是验证CT在识别局部晚期（T3/4）或淋巴结阳性结肠癌患者方面的价值。
两名放射科医生独立评估了210例结肠癌患者术前的腹部CT扫描，以确定T分期和N分期。将结果与病理结果进行比较。根据直肠癌指南，将患者分为低风险（T0/1/2和N0）或高风险（T3/4或N+）患者。
观察者间的相关性很高，超过90%。T分期的总体敏感性为93.0%，N分期为76.9%。使用CT扫描识别局部晚期（T3/4或N+）肿瘤时，一致敏感性为94.9%，特异性为53.6%，阳性预测值（PPV）为92.8%，阴性预测值（NPV）为62.5%。
根据直肠癌指南，计算机断层扫描是识别适合新辅助治疗的结肠癌患者的有效工具。
