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局部晚期直肠癌新辅助放化疗后病理完全缓解的形态学预测指标

Morphologic predictors of pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer.

作者信息

Zhang Chongda, Ye Feng, Liu Yuan, Ouyang Han, Zhao Xinming, Zhang Hongmei

机构信息

Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10021, China.

出版信息

Oncotarget. 2017 Dec 19;9(4):4862-4874. doi: 10.18632/oncotarget.23419. eCollection 2018 Jan 12.

Abstract

PURPOSE

To evaluate the value of morphological parameters that can be obtained conveniently by MRI for predicting pathologically complete response (pCR) in patients with rectal cancer.

MATERIALS AND METHODS

A cohort of 101 patients was examined using MRI before and after Neoadjuvant chemoradiotherapy (nCRT). Morphological parameters including maximum tumor area (MTA), maximum tumor length (MTL) and maximum tumor thickness (MTT), as well as cylindrical approximated tumor volume (CATV), distance to anal verge (DTA), and the reduction rates were evaluated by two experienced readers independently.

RESULTS

Post-nCRT MTA and MTL, reduction rates and pre-nCRT DTA were proved to be significantly different between pCR and non-pCR with the AUCs of 0.672-0.853. The sensitivity and specificity for assessing pCR were 61.1-89.9% and 59.0-80.7% respectively. No significant correlation between pre-nCRT size measurements and pCR was obtained.

CONCLUSION

The convenient morphological measurements may be useful for predicting pCR with moderate sensitivity and specificity. Combining these predictors with the aim of building diagnostic model should be explored.

摘要

目的

评估通过磁共振成像(MRI)能够便捷获取的形态学参数对预测直肠癌患者病理完全缓解(pCR)的价值。

材料与方法

对101例患者在新辅助放化疗(nCRT)前后进行MRI检查。两名经验丰富的阅片者独立评估包括最大肿瘤面积(MTA)、最大肿瘤长度(MTL)、最大肿瘤厚度(MTT)等形态学参数,以及柱状近似肿瘤体积(CATV)、距肛缘距离(DTA)和缩小率。

结果

pCR组与非pCR组在新辅助放化疗后MTA、MTL、缩小率及新辅助放化疗前DTA方面存在显著差异,曲线下面积(AUC)为0.672 - 0.853。评估pCR的敏感性和特异性分别为61.1% - 89.9%和59.0% - 80.7%。新辅助放化疗前的大小测量值与pCR之间未发现显著相关性。

结论

便捷的形态学测量对于预测pCR具有一定价值,其敏感性和特异性中等。应探索将这些预测指标相结合以构建诊断模型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ad8/5797018/a8c61fe00c8f/oncotarget-09-4862-g001.jpg

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