在直肠癌中使用新辅助疗法后,用于结节重置的MRI,并进行了他的病理学比较
Zhiwen Zhang1, Yan Chen1, Ziqiang Wen1
1Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 510080, Guangzhou, China.
概括
欧洲胃肠道和腹部放射学学会 (ESGAR) 的标准显示,在新辅助疗法后检测直肠癌在淋巴结中的转移,其准确度中等. 形态特征不会改善5毫米或更大的节点的诊断.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 胃肠病学 胃肠病学
背景情况:
- 结直肠癌患者在新辅助疗法后往往会出现淋巴结缩小的情况.
- 在MRI治疗后检测到的LNs存在转移的风险.
- 准确的LN评估对于治疗计划和预后至关重要.
研究的目的:
- 评估ESGAR标准的诊断性能 (短轴直径≥5毫米) 对于恶性直肠癌患者的恶性直肠癌患者在新辅助治疗后.
- 为了确定节点形态特征是否提高了LNs≥5mm的诊断效率.
主要方法:
- 对90名经过新辅助治疗和手术前MRI手术的局部晚期直肠癌患者进行了回顾性研究.
- 两个放射科医生对LN短轴直径和形态特征 (形状,边缘,均性) 的独立评估.
- ROC曲线分析,以评估尺寸标准的诊断性能,以基因病理为参考标准.
主要成果:
- 总共分析了298个LN. 节点大小曲线下的面积 (AUC) 为0.81.1.
- 在5毫米的切割值,灵敏度为65.9%,特异性为87.0%,PPV为46.8%,NPV为93.6%,准确度为83.9%.
- 在良性和恶性LNs≥5mm (P>0.05) 之间没有发现形态特征的显著差异.
结论:
- 根据ESGAR标准,在接受新辅助治疗后的直肠癌患者中,恶性LNs的诊断性能适度.
- 该标准对于LNs<5mm有效,但对于LNs≥5mm则不那么有效.
- 节点形态特征没有提高LNs≥5mm的诊断效率.
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