基于“DISTANCE”结构报告的MRI对T3期直肠癌预后的预测

MRI for prognosis prediction of T3-stage rectal cancer based on "DISTANCE" structural report.

作者信息

Xie Yuen, Chen Jiaqi, Song Rui, Tang Yehuan, Chen Peiyin, Yang Chongze, Deng Chengdi, Li Hui, Liao Jinyuan, Long Liling

机构信息

First Affiliated Hospital of GuangXi Medical University, Nanning, China.

Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor of Guangxi Medical University, Nanning, China.

出版信息

Abdom Radiol (NY). 2025 Aug 9. doi: 10.1007/s00261-025-05126-0.

DOI:10.1007/s00261-025-05126-0

PMID:40782257

Abstract

PURPOSE

To explore whether magnetic resonance imaging (MRI) features, when employed with the MRI structural report "DISTANCE," allow the prediction of the overall survival (OS) and progression-free survival (PFS) of patients with T3-stage rectal cancer and to provide information for improved preoperative diagnosis and prognosis evaluation of T3-stage rectal cancer.

METHODS

This is a retrospective analysis of 205 cases of T3-stage rectal cancer from January 2014 to January 2021. Univariate, multivariate, and LASSO Cox regression analyses were performed to identify prognostic factors, construct OS and PFS feature nomograms, evaluate the value of MRI features in predicting OS and PFS, and visualize their impact on OS and PFS using Kaplan-Meier survival curves.

RESULTS

The circumferential resection margin (CRM), obturator lymph node (Obturator N), extramural depth (EMD), maximum short axis of lymph node (maximum short axis of N), and mrEMVI were identified as independent predictors of OS and PFS. The nomogram model predicted the AUCs of OS at 2, 3, and 5 years as 0.806, 0.775, and 0.815, respectively, and those for PFS as 0.695, 0.729, and 0.726 at 2, 3, and 5 years, respectively.

CONCLUSION

The CRM, EMD, Obturator N, maximum short axis of N, and mrEMVI from the MRI structural report "DISTANCE" should be employed for the prognosis prediction of T3-stage rectal cancer.

摘要

目的

探讨磁共振成像（MRI）特征结合MRI结构报告“DISTANCE”能否预测T3期直肠癌患者的总生存期（OS）和无进展生存期（PFS），并为改善T3期直肠癌的术前诊断和预后评估提供信息。

方法

这是一项对205例2014年1月至2021年1月期间的T3期直肠癌患者的回顾性分析。进行单因素、多因素和LASSO Cox回归分析以识别预后因素，构建OS和PFS特征列线图，评估MRI特征在预测OS和PFS方面的价值，并使用Kaplan-Meier生存曲线直观显示其对OS和PFS的影响。

结果

环周切缘（CRM）、闭孔淋巴结（Obturator N）、壁外深度（EMD）、淋巴结最大短轴（N的最大短轴）和mrEMVI被确定为OS和PFS的独立预测因素。列线图模型预测OS在2年、3年和5年时的AUC分别为0.806、0.775和0.815，PFS在2年、3年和5年时的AUC分别为0.695、0.729和0.726。