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比较 MRI 评估的局部进展期低位直肠癌复发风险因素与纵向切片病理分析结果。

Comparison of Risk Factors for Locally Advanced Lower Rectal Cancer Recurrence Evaluated by Magnetic Resonance Imaging and Pathological Factors Analysed by Longitudinal Slicing Method.

机构信息

Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Japan.

Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan.

出版信息

Anticancer Res. 2021 Jun;41(6):3169-3178. doi: 10.21873/anticanres.15103.

Abstract

BACKGROUND/AIM: We compared the risk factors for locally advanced lower rectal cancer (LALRC) recurrence evaluated by preoperative magnetic resonance imaging (MRI) and pathological factors analysed via the longitudinal slicing method to identify high risk groups for recurrence.

PATIENTS AND METHODS

This retrospective single-institution cohort study analysed 45 consecutive patients who underwent curative surgery for LALRC. Data were analysed by an experienced radiologist and pathologist.

RESULTS

Final preoperative extramural venous invasion (EMVI) and extramural depth of invasion (EMD) determined via MRI were significantly associated with EMVI and EMD determined via pathological analysis. The log-rank test for disease-free survival based on initial preoperative factors showed significantly poor prognoses for circumferential resection margin (CRM)-positive, EMVI-positive, and EMD-positive patients.

CONCLUSION

Final preoperative EMVI and EMD determined via MRI correlated with pathological EMVI and EMD, especially in patients who did not undergo preoperative treatment. CRM, EMVI, and EMD determined via preoperative MRI were significant risk factors for recurrence.

摘要

背景/目的:我们比较了术前磁共振成像(MRI)评估的局部晚期低位直肠癌(LALRC)复发的危险因素和通过纵向切片方法分析的病理因素,以确定复发的高危人群。

患者和方法

这项回顾性单中心队列研究分析了 45 例接受 LALRC 根治性手术的连续患者。数据由经验丰富的放射科医生和病理科医生进行分析。

结果

最终术前磁共振成像(MRI)确定的壁外静脉侵犯(EMVI)和壁外浸润深度(EMD)与通过病理分析确定的 EMVI 和 EMD 显著相关。基于初始术前因素的无病生存对数秩检验显示,CRM 阳性、EMVI 阳性和 EMD 阳性的患者预后明显较差。

结论

最终术前 MRI 确定的 EMVI 和 EMD 与病理 EMVI 和 EMD 相关,尤其是在未接受术前治疗的患者中。术前 MRI 确定的 CRM、EMVI 和 EMD 是复发的显著危险因素。

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