MRI观察壁外血管侵犯评估直肠癌新辅助治疗后根治性手术患者预后  

MRI diagnosis of extramural vascular invasion for assessing prognosis of rectal cancer patients after neoadjuvant therapy and radical resection

作　　者：陈楚瑶 赵茜茜[1] 许乙凯[1] CHEN Chuyao;ZHAO Xixi;XU Yikai(Medical Imaging Center,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院影像中心,广东广州510515

出　　处：《中国医学影像技术》2020年第12期1848-1852,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨MRI观察直肠壁外血管侵犯(mrEMVI)以评估直肠癌新辅助治疗(NAT)及根治术后患者预后的价值。方法回顾性分析61例于NAT后接受根治性手术的直肠癌患者,均于NAT前接受3.0T高分辨率MR检查,分为mrEMVI阳性组与阴性组,对比2组相关资料;术后随访,统计3年无瘤生存率(DFS),采用COX单因素及多因素回归分析观察DFS影响因素。结果 mrEMVI阳性组31例,阴性组30例, MRI所示组间T分期、浸润深度、肿瘤位置及环周切缘阳性率差异均有统计学意义(P均<0.05)。中位随访时间29个月[95%CI(1.1,50.0)],mrEMVI阴性患者3年DFS为82.5%,明显高于mrEMVI阳性者(48.8%,P=0.013)。mrEMVI及病理分级可预测3年DFS(P均<0.05)。结论 mrEMVI可用于评估直肠癌NAT及根治术后患者预后。Objective To explore MRI evaluation on extramural vascular invasion(mrEMVI)for assessing prognosis of patients with rectal cancer after neoadjuvant therapy(NAT)and radical resection.Methods Data of 61 patients with pathologically confirmed rectal cancer who received NAT and radical resection were retrospectively analyzed.High resolution MR examinations were performed with 3.0T MR system before NAT,the patients were divided into positive and negative mrEMVI groups,and the relevant data were compared between groups.Postoperative follow-up was conducted,and 3-year disease free survival(DFS)was calculated.COX single-factor and multi-factor regression analysis were used to observe the impact factors of DFS.Results There were 31 cases in positive mrEMVI group and 30 in negative mrEMVI group.Significant differences of T stage,tumor invasion depth,tumor location and positive rate of circumferential resection margin(CRM)on MRI were found between groups(all P<0.05).The overall median follow-up was 29 months(95%CI[1.1,50.0]).The 3-year DFS of mrEMVI negative group was 82.5%,higher than that of mrEMVI positive group(48.8%,P=0.013).mrEMVI and pathological grade could predict 3-year DFS of rectal cancer patients after NAT and radical resection(both P<0.05).Conclusion mrEMVI could be used to evaluate prognosis of rectal cancer patients after neoadjuvant therapy.

关 键 词：结直肠肿瘤 磁共振成像 新辅助治疗 壁外血管侵犯 

分 类 号：R735.3[医药卫生—肿瘤] R445.2[医药卫生—临床医学]