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一种通过结合术前磁共振成像征象和肿瘤标志物预测直肠癌淋巴结转移的列线图模型。

A nomogram model for predicting lymph node metastasis of rectal cancer by combining preoperative magnetic resonance imaging signs and tumour markers.

作者信息

Xu Meihai, Wang Zheng, Qiao Xiu-Feng, Liao Hai, Su Dan-Ke

机构信息

Guangxi Medical University Cancer Hospital, China.

The Fifth Affiliated Hospital of Guangxi Medical University, China.

出版信息

Pol J Radiol. 2025 Mar 7;90:e114-e123. doi: 10.5114/pjr/200612. eCollection 2025.

Abstract

PURPOSE

This study aimed to explore the diagnostic value of high-resolution magnetic resonance images and tumour markers in predicting lymph node metastasis of rectal cancer.

MATERIAL AND METHODS

The clinical, imaging, and pathological data of patients with suspected rectal cancer were collected. The baseline data, and surgical and pathological characteristics were compared between the lymph node metastasis group and no metastasis group. Univariate and multivariate logistic regression were used to analyse the clinical and pathological factors, and preoperative magnetic resonance imaging (MRI) signs of extramural vascular invasion and rectal cancer lymph node metastasis. A nomogram model was established with statistically significant factors.

RESULTS

150 patients were included. Among them, 50 (33.3%) presented with vascular tumour thrombus, and 72 (48.0%) had lymph node metastasis. The detection of regional lymph nodes (DWI-LN) was an independent risk factor for lymph node metastasis. The area under curve of the nomogram model was 0.804.

CONCLUSION

Preoperative serum CA19.9, and the relationship between tumour and peritoneal reflection in preoperative MRI and DWI-LN have clinical value in predicting lymph node metastasis in patients with rectal cancer.

摘要

目的

本研究旨在探讨高分辨率磁共振成像及肿瘤标志物在预测直肠癌淋巴结转移中的诊断价值。

材料与方法

收集疑似直肠癌患者的临床、影像及病理资料。比较淋巴结转移组和无转移组的基线数据、手术及病理特征。采用单因素和多因素逻辑回归分析临床病理因素以及术前磁共振成像(MRI)提示的壁外血管侵犯和直肠癌淋巴结转移征象。利用具有统计学意义的因素建立列线图模型。

结果

纳入150例患者。其中,50例(33.3%)出现血管肿瘤血栓,72例(48.0%)发生淋巴结转移。区域淋巴结检测(DWI-LN)是淋巴结转移的独立危险因素。列线图模型的曲线下面积为0.804。

结论

术前血清CA19.9以及术前MRI中肿瘤与腹膜反折的关系和DWI-LN在预测直肠癌患者淋巴结转移方面具有临床价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4134/12049155/e5a7c54a5d8c/PJR-90-200612-g001.jpg

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