分子影像学杂志2025，Vol.48Issue(6)：711-718,8.DOI:10.12122/j.issn.1674-4500.2025.06.08
临床因素对局部进展期结直肠癌患者新辅助放化疗后病理完全缓解的预测价值
Predictive value of clinical factors for pathological complete response following neoadjuvant chemoradiotherapy in locally advanced colorectal cancer patients
摘要
Abstract
Objective To investigate the clinical factors influencing pathological complete response(pCR)after neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer(LARC).Methods A retrospective analysis was conducted on the clinical data of 122 LARC patients admitted to the First Affiliated Hospital of Bengbu Medical University from January 2017 to June 2023.Univariate analysis and binary logistic multivariate regression analysis were used to examine the clinical factors affecting pCR,while ROC curve analysis was further employed to validate the predictive accuracy of certain indicators for pCR.Results Among the 122 enrolled patients,27(22.13%)achieved pCR.Univariate analysis revealed that extramural venous invasion(EMVI),pretreatment carcinoembryonic antigen(CEA)level,perineural invasion,lymphovascular invasion,circumferential tumor extent,and tumor length were statistically correlated with pCR.The Hosmer-Lemeshow test showed a goodness-of-fit significance of 0.168.ROC curve analysis of MRI-measured tumor length yielded an AUC of 0.706,with a sensitivity of 85.3%and specificity of 59.3%,and the optimal cutoff value was 1.65 cm.For CEA in predicting pCR,the AUC was 0.632,with a sensitivity of 42.1%and specificity of 88.9%,and the optimal cutoff value was 4.955 ng/mL.Multivariate analysis identified lymphovascular invasion,circumferential tumor extent,and tumor longitudinal length as independent predictors of pCR.Conclusion Lymphovascular invasion,circumferential tumor extent,and tumor length may be critical determinants for achieving pCR after neoadjuvant chemoradiotherapy in LARC patients.关键词
局部晚期结直肠癌/新辅助治疗/病理完全缓解/肿瘤消退等级/癌胚抗原水平Key words
locally advanced colorectal cancer/neoadjuvant therapy/pathological complete remission/tumor regression grade/carcinoembryonic antigenlevel引用本文复制引用
蒋蝶,韩秀美,陶杰,王睿朋,朱超莽,李多杰,殷红梅..临床因素对局部进展期结直肠癌患者新辅助放化疗后病理完全缓解的预测价值[J].分子影像学杂志,2025,48(6):711-718,8.基金项目
大健康研究院区域性疾病联合研究中心专项资金(2024bydjk009) （2024bydjk009）
