中国实用外科杂志2019，Vol.39Issue(4)：365-369,5.DOI:10.19538/j.cjps.issn1005-2208.2019.04.19
MRI测量原发肿瘤体积对cT3期低位直肠癌预后指导价值研究
The prognostic significance of primary tumor volume by MRI in cT3 low rectal cancer
摘要
Abstract
Objective To evaluate the clinical significance of primary tumor volume (PTV) by preoperative highresolution MRI measurement in subgroup of cT3 low rectal cancer. Methods A total of 99 patients with low rectal cancer who confirmed by pathology and assessed at stage-cT3 by MRI, did not undergo neoadjuvant chemoradiotherapy (nCRT) treated in Department of Colorectal Surgery, Fujian Medical University Union Hospital from June 2010 to December 2012 were adopted in the study. The relations between PTV and the depths of tumor infiltration out of mesorectum were analyzed through Spearman correlation analysis. The receiver-operating characteristic (ROC) curve was used to analyze the PTV and 3-year disease-free survival. Cox proportional hazard model was performed for influence factors analysis. Results The depth of tumor infiltration mesorectum and the PTV were revealed significantly correlated (P<0.001, r=0.457). The average PTV was 2.1-56.5 (16.4±10.3) cm3.ROC showed the best cutoff point of PTV 14.8 cm3, the area under the curve was 0.829 (95％CI 0.745-0.913, P<0.001). Taking the integer 15 cm3 or 14.8 cm3, the authors divided the patients into PTV≤ 15 cm3/> 15 cm3 or PTV≤14.8 cm3/>14.8 cm3.The difference between groups revealed significant in the 3-year disease-free survival rate, the local recurrence rate and the distant metastases rate.COX regression analysis was utilized for 3-year disease-free survival, and the multivariate analysis indicated that PTV was an independent impact factor (HR=0.180, 95％CI 0.078-0.415, P<0.05). Conclusion The primary tumor volume (PTV) by preoperative high-resolution MRI measurement might be used as a new prognostic parameter for cT3 low rectal cancer.关键词
低位直肠癌/T3分期/肿瘤体积/预后Key words
low rectal cancer/T3 subgroups/tumor volume/prognosis分类
医药卫生引用本文复制引用
黎凡,林维文,官国先,蒋伟忠,刘星,陈致奋..MRI测量原发肿瘤体积对cT3期低位直肠癌预后指导价值研究[J].中国实用外科杂志,2019,39(4):365-369,5.基金项目
2017年厦门市肿瘤医院青年科研基金资助项目(No.ZLYYB201703) （No.ZLYYB201703）
