中国taTME病例登记协作研究数据库中直肠癌手术标本质量分析:一项全国性登记研究  

Quality analysis of surgical specimens of rectal cancer in the Chinese taTME registry collaborative database:a nationwide registered study

作　　者：魏鹏宇 任明扬[2] 张宏宇[3] 王权[4] 徐庆[5] 于刚 陈建志 张宏[8] 肖毅[9] 吴淼[10] 李杨[1] 刘怡杉 姚宏伟[1] 张忠涛[1] Wei Pengyu;Ren Mingyang;Zhang Hongyu;Wang Quan;Xu Qing;Yu Gang;Chen Chienchih;Zhang Hong;Xiao Yi;Wu Miao;Li Yang;Liu Yishan;Yao Hongwei;Zhang Zhongtao(Department of General Surgery,Beijing Friendship Hospital,National Clinical Research Center for Digestive Diseases,Clinical Practice and Research Center for Colorectal Cancer,Capital Medical University,Beijing 100050,China;Department of Gastrointestinal Surgery,Nanchong Central Hospital,North Sichuan Medical College,Nanchong 637900,Sichuan Province,China;Department of Gastrointestinal Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042,China;Department of Gastrointestinal Surgery,the First Hospital of Jilin University,Changchun 130021,China;Department of Gastrointestinal Surgery,Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;Department of Colorectal Surgery,Zibo Municipal Hospital,Zibo 255200,Shandong Province,China;Division of Colorectal Surgery,Koo Foundation Sun Yat‐Sen Cancer Center,Taipei 112019,China;Department of Colorectal Oncology Surgery,Shengjing Hospital of China Medical University,Shenyang 110004,China;Department of General Surgery,Peking Union Medical College Hospital,Beijing 100730,China;Department of Gastrointestinal Hernia Surgery,the Second People′s Hospital of Yibin,Yibin 644000,Sichuan Province,China)

机构地区：[1]首都医科大学附属北京友谊医院普通外科、国家消化系统疾病临床医学研究中心、首都医科大学结直肠肿瘤临床诊疗与研究中心,北京100050 [2]川北医学院南充中心医院胃肠外科,南充637900 [3]重庆医科大学附属第一医院胃肠外科,重庆400042 [4]吉林大学第一医院胃肠外科,长春130021 [5]上海交通大学医学院附属仁济医院胃肠外科,上海200127 [6]淄博市市立医院结直肠外科,淄博255200 [7]和信治癌中心医院结直肠外科,台北112019 [8]中国医科大学附属盛京医院结直肠肿瘤外科,沈阳110004 [9]北京协和医院基本外科,北京100730 [10]宜宾市第二人民医院胃肠疝外科,宜宾644000

出　　处：《中华消化外科杂志》2023年第6期736-741,共6页Chinese Journal of Digestive Surgery

基　　金：国家重点研发计划资助(2017YFC0110904);北京市临床重点专科基金(2018⁃118);首都医科大学结直肠肿瘤临床诊疗与研究中心专项基金(1192070313);首都医科大学附属北京友谊医院科研启动基金(YYQDKT2016⁃5)。

摘　　要：目的分析中国经肛全直肠系膜切除术(taTME)病例登记协作研究(CTRC)数据库中直肠癌手术标本质量。方法采用回顾性描述性研究方法。基于真实世界研究理念,收集2017年11月15日至2022年12月31日CTRC数据库中首都医科大学附属北京友谊医院等40家医学中心收治的1761例直肠癌行taTME患者的临床病理资料;男1212例,女549例;年龄为62(53~68)岁。观察指标:(1)术前检查情况。(2)新辅助治疗情况。(3)术后检查情况。偏态分布的计量资料以M(范围)表示。计数资料以绝对数表示。结果(1)术前检查情况。1761例患者中,1324例行术前盆腔磁共振成像(MRI)检查,其中临床T0期4例、T1期30例、T2期250例、T3期828例、T4期141例、Tx期11例,数据缺失60例;临床N0期490例、N1期373例、N2期311例、Nx期86例,数据缺失64例;156例直肠系膜筋膜受侵犯,223例肠壁外血管受侵犯;肿瘤下缘距肛缘距离为50(40~60)mm。(2)新辅助治疗情况。1761例患者中,873例行新辅助治疗,其中单纯放疗17例、单纯化疗155例、短程同步放化疗43例、短程同步放化疗+延迟手术26例、接触放疗1例、长程同步放化疗277例、其他9例,数据缺失345例。(3)术后检查情况。1761例患者中,行R_(0)切除、R_(1)切除、R_(2)切除分别为1584、23、1例,数据缺失153例;肿瘤最大径为30(20~45)mm,获取淋巴结数目为13(10~17)枚,脉管内癌栓阳性率为20.794%(330/1587);1647例记录环周切缘情况,环周切缘阳性51例,肿瘤深部距环周切缘最小距离为5(3~13)mm;547例记录远端切缘情况,远端切缘阳性4例,肿瘤下缘距远端切缘距离为20(10~25)mm。1698例记录标本完整性情况,标本完好、一般、不佳、未评估分别为1436、233、8、21例。20例发生肠管穿孔。1761例患者中,病理学T0期、Tis期、T1期、T2期、T3期、T4期分别为103、23、145、515、712、179例,病理学无法评估4例,数据缺失80例;病理学N0期、N1a期、N1b期、N1c期Objective To analyze the quality of surgical specimens of rectal cancer in the Chinese transanal total mesorectal excision(taTME)registry collaborative(CTRC)database.Methods The retrospective and descriptive study was conducted.Based on the concept of real‑world research,the clinicopathological data of 1761 patients with rectal cancer in the CTRC database who underwent taTME in 40 medical centers,including the Beijing Friendship Hospital of Capital Medical University et al,from November 15,2017 to December 31,2022 were collected.There were 1212 males and 549 females,aged 62(range,53−68)years.Observation indicators:(1)preoperative examinations;(2)neoadjuvant therapy;(3)postoperative examinations.Measurement data with skewed distribution were represented as M(range).Count data were described as absolute numbers.Results(1)Preoperative examinations.Of the 1761 patients,1324 patients underwent preoperative pelvic magnetic resonance imaging examination,and the results showed that 4 cases as clinical T0 stage,30 cases as clinical T1 stage,250 cases as clinical T2 stage,828 cases as clinical T3 stage,141 cases as clinical T4 stage,11 cases as clinical Tx stage,60 cases missing clinical T staging data,490 cases as clinical N0 stage,373 cases as clinical N1 stage,311 cases as clinical N2 stage,86 cases as clinical Nx stage,64 cases missing clinical N staging data,156 cases with mesorectal fascia invasion,223 cases with extraintestinal blood vessels invasion.The distance from lower margin of tumor to anal margin of 1324 patients was 50(range,40−60)mm.(2)Neoadjuvant therapy.Of the 1761 patients,873 patients underwent neoadjuvant therapy,including 17 cases receiving radiotherapy alone,155 cases receiving chemotherapy alone,43 cases receiving short‑course simultaneous chemoradiotherapy,26 cases receiving short‑course simultaneous chemoradiotherapy and delayed surgery,1 case receiving contact radiotherapy,277 cases receiving long‑course simultaneous chemoradiotherapy,9 cases receiving other treatments,and 345 cases

关 键 词：直肠肿瘤 经肛全直肠系膜切除 中国经肛全直肠系膜切除病例登记协作研究数据库 登记研究 手术标本 组织病理学 

分 类 号：R735.37[医药卫生—肿瘤]