实用临床医药杂志2025，Vol.29Issue(22)：18-23,6.DOI:10.7619/jcmp.20250408
高分辨率磁共振成像联合CALLY指数对局部晚期直肠癌患者壁外血管侵犯的预测价值
Predictive value of high-resolution magnetic resonance imaging combined with CALLY index for extramural vascular invasion in patients with locally advanced rectal cancer
摘要
Abstract
Objective To investigate the predictive value of high-resolution magnetic resonance imaging(HR-MRI)combined with CALLY index for extramural vascular invasion(EMVI)in pa-tients with locally advanced rectal cancer(LARC)before neoadjuvant chemoradiotherapy(NCRT).Methods A total of 129 patients with LARC were retrospectively selected as the study subjects.The HR-MRI imaging features and relevant serological indicators before NCRT were collected,and the CALLY index[a composite index composed of C-reactive protein(CRP),lymphocyte(LYM)count,and albumin(ALB)]was calculated.According to the postoperative pathological results,the patients were divided into EMVI-positive group(48 cases)and EMVI-negative group(81 cases).Logistic regression analysis was used to screen the influencing factors for the occurrence of EMVI.The receiver operating characteristic(ROC)curve was drawn to evaluate the predictive efficacy of the CALLY index and HR-MRI assessment results for EMVI.Results The proportion of patients with T stage of T3～4 and the proportion of patients with positive EMVI assessed by HR-MRI in the EMVI-positive group were higher than those in the EMVI-negative group(P＜0.05).The levels of CRP,neutro-phils(NEU),carcinoembryonic antigen(CEA),and red blood cell distribution width(RDW)in the EMVI-positive group were higher than those in the EMVI-negative group,while the levels of LYM,ALB,and CALLY index were lower than those in the EMVI-negative group,with statistically signifi-cant differences(P＜0.05).Multivariate Logistic regression analysis showedthat age,T stage,HR-MRI assessment result of EMVI,CEA and CALLY index were all independent influencing factors for EMVI positivity in patients with LARC(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of the CALLY index for predicting EMVI before NCRT was 0.757(95％CI,0.674 to 0.828),the AUC of the HR-MRI assessment result was 0.779(95％CI,0.697 to 0.847),and the AUC of the combined prediction of the two was 0.870(95％CI,0.799 to 0.923).Conclusion HR-MRI combined with CALLY index before NCRT has a high predictive value for EMVI in patients with LARC and can provide an important reference for individualized treatment.关键词
局部晚期直肠癌/壁外血管侵犯/高分辨率磁共振成像/CALLY指数/C反应蛋白/淋巴细胞/白蛋白/新辅助放化疗Key words
locally advanced rectal cancer/extramural vascular invasion/high-resolution magnetic resonance imaging/CALLY index/C-reactive protein/lymphocyte/albumin/neoadjuvant chemoradiotherapy分类
医药卫生引用本文复制引用
WANG Jun,WANG Zhenchuan,YANG Liuqing..高分辨率磁共振成像联合CALLY指数对局部晚期直肠癌患者壁外血管侵犯的预测价值[J].实用临床医药杂志,2025,29(22):18-23,6.基金项目
陕西省卫生健康科研基金项目(2021D102) （2021D102）
