Zhang Wen-Yi, Chen Xing-Xing, Chen Wen-Hao, Zhang Hui, Zou Chang-Lin
Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Gastroenterol Res Pract. 2018 Mar 18;2018:6976375. doi: 10.1155/2018/6976375. eCollection 2018.
The aim of this study was to identify if blood routine parameters and serum tumor marker are potential predictive factors for tumor response to preoperative chemoradiotherapy (CRT) in locally advanced rectal cancer.
55 locally advanced rectal cancer patients were treated with preoperative CRT in this study. The total dose of preoperative radiotherapy was 45 Gy in 25 fractions of 1.8 in 5 weeks. All patients concurrently received 825 mg/m capecitabine orally twice daily on days 1 to 14 and 22 to 35. Total mesorectal excision (TME) was performed 6 weeks after the end of preoperative CRT. Blood routine examination and serum tumor marker were checked before preoperative CRT. Tumor response to preoperative CRT was evaluated with the semiquantitative tumor regression grading (TRG) system proposed by Dworak criteria according to histopathological examination of the surgical specimens. Univariable and multivariable logistic regression analyses were used to test the association between blood routine parameters and serum tumor marker and tumor response to preoperative CRT.
Univariate logistic regression analysis revealed that differentiation, lymphocyte, LMR, MCV, PLR, and CEA have been significantly associated with tumor response to preoperative CRT. Multivariate logistic regression analysis revealed that differentiation, MCV, and CEA were the predictors of tumor response to preoperative CRT. According to the ROC analysis, the AUC of differentiation, MCV, and CEA was 0.794, 0.802, and 0.723, respectively. Optimal cutoff points for MCV and CEA were 87.65 fl and 4.05 ng/ml, respectively.
MCV is a potential predictive factor for tumor response to preoperative chemoradiation in locally advanced rectal cancer.
本研究旨在确定血常规参数和血清肿瘤标志物是否为局部晚期直肠癌术前放化疗（CRT）疗效的潜在预测因素。
本研究中55例局部晚期直肠癌患者接受了术前CRT治疗。术前放疗总剂量为45 Gy，分25次，每次1.8 Gy，共5周。所有患者在第1至14天和第22至35天同时口服825 mg/m²卡培他滨，每日两次。术前CRT结束6周后行全直肠系膜切除术（TME）。术前CRT前检查血常规和血清肿瘤标志物。根据手术标本的组织病理学检查，采用Dworak标准提出的半定量肿瘤消退分级（TRG）系统评估术前CRT的肿瘤反应。采用单因素和多因素logistic回归分析来检验血常规参数和血清肿瘤标志物与术前CRT肿瘤反应之间的关联。
单因素logistic回归分析显示，分化程度、淋巴细胞、LMR、MCV、PLR和CEA与术前CRT的肿瘤反应显著相关。多因素logistic回归分析显示，分化程度、MCV和CEA是术前CRT肿瘤反应的预测因素。根据ROC分析，分化程度、MCV和CEA的AUC分别为0.794、0.802和0.723。MCV和CEA的最佳截断点分别为87.65 fl和4.05 ng/ml。
MCV是局部晚期直肠癌术前放化疗疗效的潜在预测因素。
