Lee Matthew H, Hinshaw J Louis, Kim David H, Pickhardt Perry J
Department of Radiology, University of Wisconsin, 600 Highland Ave., Madison, WI 53792-3252.
Department of Radiology, University of Wisconsin, 600 Highland Ave., Madison, WI 53792-3252.
Acad Radiol. 2016 Jun;23(6):712-7. doi: 10.1016/j.acra.2015.12.009. Epub 2016 Feb 3.
Computed tomographic colonography (CTC) is a robust tool for evaluating colorectal lesions in both screening and diagnostic settings. The purpose of this study was to assess the relationship between colorectal cancer (CRC) tumor characteristics and patient symptomatology.
This is a retrospective analysis of all pathology-confirmed cases of CRC evaluated with CTC at our institution from October 2004 to October 2012. Cases were reviewed to determine tumor size, morphology, and degree of luminal narrowing. An electronic medical record review was performed to delineate specific patient symptomatology and determine depth of invasion.
A total of 55 patients (36 symptomatic and 19 asymptomatic) with a total of 63 CRCs were evaluated by CTC during the study time period. The most common symptoms were gastrointestinal (GI) bleeding/anemia (n = 26), followed by obstructive symptoms (n = 23), and constitutional symptoms (n = 5). Symptomatic cancers were more likely to have annular morphology (n = 30/43, 70% vs. n = 3/20, 15%; odds ratio [OR] = 13.1, P = 0.0003), whereas asymptomatic cancers were more likely to be polypoid (n = 11/20, 55% vs. n = 6/43, 14%, OR = 7.5, P = 0.001). Symptomatic cancers were also larger (46.1 ± 22.4 vs. 38.8 ± 18.4 mm, P = 0.005) and resulted in greater luminal narrowing (8.7 ± 8.5 mm vs. 35.8 ± 18.8 mm, P < 0.0001) with deeper invasion (n = 29/35 [invasion unknown for 8 cases], 83% vs. n = 6/20, 30%, OR = 11.3, P = 0.0003). Invasive cancers were more likely to have annular morphology (66%, 23/25, P = 0.002).
There is an intuitive and predictable relationship between tumor characteristics on CTC and patient symptoms. Annular morphology, tumor size, degree of luminal narrowing, and invasive disease all correlate with the presence of symptoms.
计算机断层结肠成像（CTC）是在筛查和诊断环境中评估结直肠病变的有力工具。本研究的目的是评估结直肠癌（CRC）肿瘤特征与患者症状之间的关系。
这是一项对2004年10月至2012年10月在本机构接受CTC评估的所有经病理确诊的CRC病例的回顾性分析。回顾病例以确定肿瘤大小、形态和管腔狭窄程度。进行电子病历回顾以描述特定患者症状并确定浸润深度。
在研究期间，共有55例患者（36例有症状，19例无症状），共63个CRC接受了CTC评估。最常见的症状是胃肠道（GI）出血/贫血（n = 26），其次是梗阻症状（n = 23）和全身症状（n = 5）。有症状的癌症更可能具有环形形态（n = 30/43，70%对n = 3/20，15%；优势比[OR] = 13.1，P = 0.0003），而无症状的癌症更可能是息肉样（n = 11/20，55%对n = 6/43，14%，OR = 7.5，P = 0.001）。有症状的癌症也更大（46.1±22.4对38.8±18.4mm，P = 0.005），导致更大的管腔狭窄（8.7±8.5对35.8±18.8mm，P < 0.0001）且浸润更深（n = 29/35[8例浸润情况未知]，83%对n = 6/20，30%，OR = 11.3，P = 0.0003）。浸润性癌症更可能具有环形形态（66%，23/25，P = 0.002）。
CTC上的肿瘤特征与患者症状之间存在直观且可预测的关系。环形形态、肿瘤大小、管腔狭窄程度和浸润性疾病均与症状的存在相关。
