CT诊断结肠癌壁外血管侵犯与患者临床病理特征的关系  

Association between extramural vascular invasion detected by MDCT and clinicopathologic characteristics in patients with colonic cancer

作　　者：周静[1] 姚旬[2] 张辉[1] 崔艳成[1] 申占龙[1] 叶颖江[1] 王屹[2] 

机构地区：[1]北京大学人民医院胃肠外科,100044 [2]北京大学人民医院放射科,100044

出　　处：《中华普通外科杂志》2017年第1期19-22,共4页Chinese Journal of General Surgery

摘　　要：目的探讨增强多排螺旋CT（contrast enhanced multi-detectors computed tomography，ceMDCT）扫描诊断结肠癌壁外血管侵犯（extramural vascular invasion，EMVI）与患者临床病理特征的关系。方法收集2009年2月至2013年12月间经根治性手术切除并获病理证实的原发结肠癌患者．TNM分期为病理诊断Ⅱ-Ⅲ期的165例患者纳入本研究。根据ceMDCT所示肿瘤侵润周围血管评分确定ctEMVI阳性或阴性。采用，检验分析ctEMVI阳性与患者临床病理特征的关系。结果本组165例结肠癌患者中，ceMDCT诊断EMVI阳性者为57例（34．5％）。ctEMVI阳性与患者的年龄〈65岁（r=4．810，P=0．031）、ceMDCT肿瘤T分期（x2=17．911，P=0．000）、ceMDCT诊断淋巴结转移（x2=5．436，P=0．022）、病理肿瘤直径≥5cm（x2=3．799，P=0．036）以及病理T分期（x2=13．346，P=0．001）均有关，而与患者的性别、BMI、肿瘤部位、血清CEA和CA19-9水平、病理淋巴结转移、肿瘤分化程度均无关（均P〉0．05）。结论ceMDCT诊断EMVI与患者的年龄、肿瘤大小和肿瘤T分期有关。Objective To investigate the association between extramural vascular invasion （EMVI） detected by multi-detectors computed tomography （MDCT） with contrast enhanced （ceMDCT） and elinicopathologic characteristics in patients with colon cancer. Methods Between February 2009 and December 2013, patients with histologically proven primary colon cancer and undergoing curative resection were included in this retrospective study. According to American Joint Committee on Cancer TNM staging system, patients of stage Ⅱ and Ⅲ were included in this study. EMVI status detected by MDCT （ctEMVI） was defined according to the EMVI scores. Chi-square test was used to analyze the association between clinicopathologic characteristics and ctEMVI. Results 165 stage Ⅱ and stage Ⅲ patients were included in this study as confirmed by pathology based on AJCC. Positive ctEMVI was demonstrated in 51 patients （34. 5% , 51/165）. There were significant association between positive ctEMVI and age 〈 65 years （X2 = 4. 810, P =0. 031 ）, ceMDCT defined tumor stage （X2 = 17. 911, P =0. 000） , eeMDCT defined metastatic lymph node （X2 = 5. 436, P = 0. 022）, tumor size ≥5 cm （X2 = 3.799, P = 0.036 ） and pathological T stage （X2 = 13. 346 ,P = 0. 001 ）. Conclusions EMVI, detected by eeMDCT, is significantly associated with age, tumor size and T staging in colon cancer.

关 键 词：结肠肿瘤 肿瘤侵润 体层摄影术 螺旋计算机 病理学 临床 

分 类 号：R735.35[医药卫生—肿瘤]