中国普通外科杂志2017，Vol.26Issue(5)：626-635,10.DOI:10.3978/j.issn.1005-6947.2017.05.015
原发灶肿瘤体积对局部进展期直肠癌新辅助放化疗后病理完全反应的预测价值
Value of primary gross tumor volume in predicting pathologic complete response of locally advanced rectal cancer following neoadjuvant chemoradiotherapy
李玉强 1裴谦 1裴海平1
作者信息
- 1. 中南大学湘雅医院 胃肠外科,湖南 长沙 410008
- 折叠
摘要
Abstract
Objective: To investigate the feasibility of using primary gross tumor volume (GTV) for predicting the pathologic complete response (pCR) to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC). Methods: The data of 107 LARC patients undergoing nCRT followed by radical surgery in Department of Gastrointestinal Surgery, Xiangya Hospital of Central South University between March 2009 and December 2015 were reviewed. The factors for predicting pCR in LARC patients after nCRT were determined. The expressions of CD133 in the tumor specimens of these patients were measured by immunohistochemical staining, and then the relationship between primary GTV and rectal cancer stem cells was analyzed. Results: In the 107 LARC patients, pCR was achieved in 25 cases (23.36%). The primary GTV was positively correlated with the length along the longitudinal axis of the bowel (r=0.580,P<0.001) and maximal diameter (r=0.608,P<0.001) of the primary tumor, while the significant differences between pCR patients and non-pCR patients were only found in primary GTV (P=0.024), serum CEA level before nCRT (P=0.020), and multiple-drug combined chemotherapy (P=0.05). The optimal cut-off values for primary GTV to estimate the response of tumor was 70.29 cm3. The results of Logistic regression analysis showed that the small primary GTV (<70 cm3) (P=0.019) and multiple-drug combined chemotherapy (P=0.032) were independent promotion factors for LARC patients to achieve pCR after nCRT. The CD133 expression in the tumor tissues of patients with large primary GTV (≥70 cm3) was significantly higher than that in patients with small primary GTV (<70 cm3) (P=0.017). Conclusion: Primary GTV can be used as an independent predictive factor for pCR in LARC patients after nCRT. Big primary GTV is associated with low pCR rate, which is probably due to the bigger the primary GTV, the larger the amount of cancer stem cells in the tumor.关键词
直肠肿瘤/放化疗,辅助/治疗结果/肿瘤干细胞Key words
Rectal Neoplasms/Chemoradiotherapy,Adjuvant/Treatment Outcome/Neoplastic Stem Cells分类
医药卫生引用本文复制引用
李玉强,裴谦,裴海平..原发灶肿瘤体积对局部进展期直肠癌新辅助放化疗后病理完全反应的预测价值[J].中国普通外科杂志,2017,26(5):626-635,10.
