临床与病理杂志2025，Vol.45Issue(11)：1470-1476,7.DOI:10.11817/j.issn.2095-6959.2025.250684
影响进展期直肠腺癌对新辅助放化疗敏感性的临床病理因素:一项回顾性病例对照研究
Clinicopathological factors influencing sensitivity to neoadjuvant chemoradiotherapy in locally advanced rectal adenocarcinoma:A retrospective case-control study
摘要
Abstract
Objective:Colorectal cancer is one of the most common malignant tumors worldwide.For locally advanced rectal adenocarcinoma(LARC),neoadjuvant chemoradiotherapy(nCRT)remains the preferred treatment.However,factors influencing sensitivity to nCRT have not been fully clarified.This study aims to explore clinical and pathological factors influencing nCRT sensitivity in patients with LARC through a retrospective case-control study. Methods:This was a retrospective case-control study.Patients with LARC treated at the Tianjin People's Hospital between January 2022 and October 2023 were included.All patients received standard long-course concurrent nCRT and underwent radical surgery within 6 to 8 weeks after completion of nCRT.Pathological tumor regression grade(pTRG)was used to assess sensitivity of LARC to nCRT.pTRG grades 0 and 1 were classified as a good response group,while pTRG grades 2 and 3 were classified as a poor response group.The following variables were collected and compared between the 2 groups:Age,gender,body mass index,comorbidities(hypertension,type 2 diabetes mellitus,hyperlipidemia),maximum tumor diameter,circumferential tumor involvement ratio,distance from the lower tumor margin to the anal verge,pre-treatment clinical tumor(cT)stage and clinical node(cN)stage.Factors with statistical significance in univariate analysis were entered into a multivariate binary Logistic regression model for multivariate analysis. Results:A total of 110 patients were included,of whom 53(48.2%)were in the good response group and 57(51.8%)were in the poor response group.The proportions of patients aged<65 years(χ2=4.638,P=0.031),with a circumferential tumor involvement ratio≤1/2(χ2=4.354,P=0.037),and with cT3(χ2=4.547,P=0.033)were significantly higher in the good response group than in the poor response group,with statistically significant differences.There were no statistically significant differences between the 2 groups in age,gender,body mass index,comorbidities(hypertension,type 2 diabetes mellitus,hyperlipidemia),maximum tumor diameter,distance from the lower tumor margin to the anal verge,or cN stage(all P>0.05).Multivariate binary Logistic regression analysis showed that age≥65 years(OR=2.375,95%CI 1.055 to 5.346,P=0.037)and a circumferential tumor involvement ratio>1/2(OR=2.407,95%CI 1.077 to 5.376,P=0.032)were independent influencing factors associated with poor treatment response. Conclusion:Age and pre-treatment circumferential tumor involvement ratio are clinicopathological factors influencing sensitivity to nCRT in patients with LARC.关键词
局部进展期直肠腺癌/新辅助放化疗/肿瘤退缩分级/敏感性/临床病理因素Key words
locally advanced rectal adenocarcinoma/neoadjuvant chemoradiotherapy/tumor regression grade/sensitivity/clinicopathological factors引用本文复制引用
刘元圣,秦海,石洋..影响进展期直肠腺癌对新辅助放化疗敏感性的临床病理因素:一项回顾性病例对照研究[J].临床与病理杂志,2025,45(11):1470-1476,7.基金项目
天津市医学重点学科建设项目(TJYXZDXK-3-009B) （TJYXZDXK-3-009B）
天津市人民医院院级课题(2022GCXK006).This work was supported by the Tianjin Key Medical Discipline Construction Project(TJYXZDXK-3-009B)and the Tianjin Union Medical Center Hospital-Level Project(2022GCXK006),China. （2022GCXK006）
