全组MRI定量参数预测直肠癌脉管侵犯及其独立危险因素筛选  

Quantitative MRI parameters in predicting vascular invasion of rectal cancer and screening of its independent risk factors

作　　者：海梦璐 张孝先 陈学军 黎如春 王贇霞 许春苗 HAI Meng-lu;ZHANG Xiao-xian;CHEN Xue-jun;LI Ru-chun;WANG Yun-xia;XU Chun-miao(Department of Radiology,Cancer Hospital of Zhengzhou University,Zhengzhou 450008,China;Department of Radiology,People’s Hospital of Henan University,Zhengzhou 450003,China)

机构地区：[1]郑州大学附属肿瘤医院,河南郑州450008 [2]河南大学人民医院,河南郑州450003

出　　处：《中国临床医学影像杂志》2024年第5期338-342,共5页Journal of China Clinic Medical Imaging

基　　金：河南省医学科技攻关联合共建项目(项目编号:LHGJ20190662)。

摘　　要：目的:探讨MRI定量参数在直肠癌脉管侵犯的预测价值。方法:回顾性分析120例直肠癌患者的临床病理及MRI资料,根据病理结果将患者分为脉管侵犯阳性组和阴性组。分析两组间临床病理及MRI特征参数的差异,并用二元Logistic回归分析直肠癌脉管侵犯的独立影响因素,采用ROC曲线下面积(AUC)评价其预测效能。结果:①本研究共入组120例患者,其中脉管侵犯阳性组38例(31.67%,38/120),脉管侵犯阴性组80例(68.33%,82/120);合并神经侵犯及淋巴结转移的直肠癌患者更易出现脉管侵犯,且在两组间的差异均有统计学意义(P值均<0.05)。②在MRI定量参数中,血管外细胞外间隙容积(Ve)值越高的患者更易出现脉管侵犯,且在两组间的差异有统计学意义(P值<0.05)。③Logistic回归分析结果显示淋巴结阳性为脉管侵犯的独立危险因素(P值<0.05),其AUC为0.911。结论:淋巴结阳性状态是直肠癌脉管侵犯的独立危险因素,且具有较高的诊断效能。Objective:To investigate the predictive value of MRI quantitative parameters in vascular invasion of rectal cancer.Methods:The clinicopathologic and MRI data of 120 patients with rectal cancer were analyzed retrospectively.According to the pathological results,the patients were divided into positive group and negative group of vascular invasion.The differences of clinicopathologic and MRI characteristic parameters between the two groups were analyzed,and the independent influencing factors of vascular invasion of rectal cancer were analyzed by binary Logistic regression.Area under the curve(AUC)of receiver operating characteristic curve(ROC)was used to evaluate its prediction efficiency.Results:①A total of 120 patients were enrolled in this study,including 38 patients(31.67%,38/120)in the positive vascular invasion group and 80 patients(68.33%,82/120)in the negative vascular invasion group.Patients with rectal cancer complicated with nerve invasion and lymph node metastasis were more likely to have vascular invasion,and the difference between the two groups was statistically significant(all P<0.05).②In MRI quantitative parameters,patients with higher Ve value were more likely to have vascular invasion,and the difference between the two groups was statistically significant(P<0.05).③Logistic regression analysis showed that positive lymph nodes were an independent risk factor for vascular invasion(P<0.05),with an AUC of 0.911.Conclusion:Lymph node positive status is an independent risk factor for vascular invasion of rectal cancer and has high diagnostic efficacy.

关 键 词：直肠肿瘤 磁共振成像 

分 类 号：R735.37[医药卫生—肿瘤] R445.1[医药卫生—临床医学]