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Radiology:直肠癌晚期壁外静脉受侵MRI征象与肿瘤复发和整体生存期的关系

2019-03-25 shaosai MedSci原创

本研究旨在评价治疗前壁外静脉受侵MRI征象(EMVI)与局灶性直肠癌晚期经新辅助放化疗后和手术后的病变进展的相关性。

本研究旨在评价治疗前壁外静脉受侵MRI征象(EMVI)与局灶性直肠癌晚期经新辅助放化疗后和手术后的病变进展的相关性。

本研究共纳入了517例局灶性直肠癌的患者。收集患者基线和治疗后MRI和随访数据。经对328例治疗后经病理证实为EMVI的患者进行评价,放射科医生评价基线MRI,主要包括EMVI表现、肿瘤大小及特点、淋巴结状态和直肠系膜筋膜受累情况。利用κ系数评价观察者间一致性。利用Kaplan-Meier曲线和COX模型评价基线MRI参数与整体生存期、无转移生存期和局部无复发生存期。

结果为,在517例患者中,男性为335 (64.8%)例,平均年龄为55.6岁± 11.5。在基线时,放射科医生诊断出259/517 (50%)例MRI有EMVI表现的患者。在调整分析后,EMVI和筋膜系膜受累时预测无转移生存期(HR分别为0.3 、 0.6; P  < .01 、 P < .02)、整体生存期(HR分别为0.5 、 0.5; P = .01 、 P = .02)的独立预测指标。仅有EMVI是与局部无复发生存期的相关指标(HR分别为0.3; P  <.01)。放射科医生评价EMVI的κ系数为0.80。

本研究表明,壁外静脉受侵(EMVI)能够可靠的在MRI上进行评价。EMVI与局灶性直肠癌晚期经新辅助放化疗和手术治疗后局部和远处复发和死亡高危风险具有显着相关性。

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