重视直肠癌术前壁外血管侵犯的意义  

Significance of paying attention to extramural vascular invasion before operation for rectal cancer

作　　者：刘晔[1] 顾磊[1] Liu Ye;Gu Lei(Department of Gastrointestinal Surgery,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院胃肠外科,上海200127

出　　处：《国际外科学杂志》2022年第5期299-305,共7页International Journal of Surgery

摘　　要：直肠癌作为常见的消化系统恶性肿瘤之一,术前精准的诊断和分期对于外科医师决定治疗方案有着重要的作用,其中壁外血管侵犯(EMVI)作为预测直肠癌淋巴结转移、远处转移和总生存期的一个重要独立因子,近年来越来越受到重视,甚至大有将其作为一种新的分期系统来指导临床治疗,制定术前准确的分期。术前MRI(mrEMVI)与病理(pEMVI)在评估EMVI的准确性上高度一致,因此mrEMVI可以作为多学科诊疗模式或者临床医师精准分析患者病情、制定个体化治疗方案的一个重要指标,也可以作为术前放化疗后(CRT)是否进行手术治疗,以及术后是否延长放化疗时间的重要评估项目,应该将其作为术前的必要检查之一。Rectal cancer is one of the most common malignant tumors of digestive system.Accurate preoperative diagnosis plays an important role in surgeons′decision on treatment plan.Extramural venous invasion(EMVI),as an important prognostic factor for predicting lymph node metastasis,distant metastasis and overall survival time of rectal cancer,has been paid more attention in recent years.It may even be used as a new staging system for guiding clinical treatment and formulate accurate preoperative staging.Preoperative MRI(mrEMVI)and postoperative pathology(pEMVI)is equal in the accuracy of assessment of EMVI.mrEMVI can be used as an important item for preoperative multi disciplinary team or clinicians to evaluate the patient stage and formulate individual treatment plan,and can also be used as an important evaluation for whether to perform surgery after preoperative chemoradiotherapy(CRT)and whether to prolong postoperative chemoradiotherapy time.EMVI should be taken as one of the necessary preoperative examinations for all the rectal cancer patients.

关 键 词：直肠肿瘤 磁共振成像 病理学 壁外血管侵犯 

分 类 号：R735.37[医药卫生—肿瘤]