Wang Fei, Huang Chuan, Ma Hai-Qing, Yao Xue-Qing, Wang Jun-Jiang, Long Jie
Department of Medical Research Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, Guangdong Province, China.
Department of Gastrointestinal Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, Guangdong Province, China.
World J Clin Oncol. 2025 Jul 24;16(7):108095. doi: 10.5306/wjco.v16.i7.108095.
Accurate identification of tumor invasion depth and lymph node (LN) involvement in patients with colon cancer (CC) is critical for guiding treatment strategies. However, the preoperative prediction of tumor invasion depth and LN metastasis in CC remains challenging. As the intestinal tumor develops, the fat density in the mesentery increases.
To investigate the efficacy of computed tomography (CT) value change in the mesentery contributed by the tumor (CT-T value) for predicting tumor invasion depth and LN metastasis.
Patients, who were diagnosed with CC and underwent surgery, were included and divided into the training and validation cohorts. CT-T values of the mesentery were extracted from the CT images. Cutoff points were determined using the receiver operating characteristic (ROC) curve, and the area under the ROC curve was employed to assess the performance of the CT-T value for tumor invasion depth and LN status prediction.
Cutoff values of 11.83 and 17.17 were identified to discriminate T1/2 T3/4 and N0 N1/2, respectively. With a cutoff CT-T value of 11.83, the total diagnostic accuracy for T stage was 83.1% (81.5% for the training cohort and 86.2% for the validation cohort). With a cutoff CT-T value of 17.17, the total diagnostic accuracy for N stage was 77.3% (75.8% for the training cohort and 80.1% for the validation cohort), which was higher than that of CT-reported LN metastasis.
In this study, we explored an efficient method for predicting preoperative T and N stages using the tumor-contributed CT value of the mesentery in CC, which displayed superior predictive accuracy.
准确识别结肠癌（CC）患者的肿瘤浸润深度和淋巴结（LN）受累情况对于指导治疗策略至关重要。然而，CC患者术前对肿瘤浸润深度和LN转移的预测仍然具有挑战性。随着肠道肿瘤的发展，肠系膜中的脂肪密度会增加。
探讨肿瘤所致肠系膜计算机断层扫描（CT）值变化（CT-T值）对预测肿瘤浸润深度和LN转移的有效性。
纳入诊断为CC并接受手术的患者，分为训练组和验证组。从CT图像中提取肠系膜的CT-T值。使用受试者工作特征（ROC）曲线确定截断点，并采用ROC曲线下面积评估CT-T值对肿瘤浸润深度和LN状态预测的性能。
分别确定截断值11.83和17.17以区分T1/2与T3/4以及N0与N1/2。CT-T值截断值为11.83时，T分期的总诊断准确率为83.1%（训练组为81.5%，验证组为86.2%）。CT-T值截断值为17.17时，N分期的总诊断准确率为77.3%（训练组为75.8%，验证组为80.1%），高于CT报告的LN转移诊断准确率。
在本研究中，我们探索了一种利用CC患者肠系膜中肿瘤所致CT值预测术前T和N分期的有效方法，其显示出卓越的预测准确性。
