在局部晚期直肠癌中接受新辅助化学放射治疗的病理完整反应的危险因素
Liangjing Zhou1, Gaoyang Cao2, Liming Shi3
1Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Frontiers in oncology
|August 4, 2025
概括
在新辅助化疗放射治疗 (nCRT) 后,在直肠癌患者中预测病理完整反应 (pCR) 是至关重要的. 组织学,CEA水平和中性粒细胞与淋巴细胞比率 (NLR) 是关键预测因素,有助于个性化治疗策略.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 大肠直肠癌是癌症死亡的主要原因,直肠癌占病例的30%.
- 新辅助化学放射治疗 (nCRT) 是局部晚期直肠癌 (LARC) 的标准,但病理完整反应 (pCR) 率仍然很低 (10-30%).
- 预测pCR对于优化LARC患者治疗策略至关重要.
研究的目的:
- 为了确定临床病理变量,预测在nCRT后LARC患者的pCR.
- 开发PCR的预测模型,以帮助治疗规划.
主要方法:
- 对285名LARC患者进行了回顾性分析,这些患者接受了nCRT和全腹膜切除 (TME) 治疗.
- 用单变量和多变量逻辑回归分析来确定pCR的预测因素.
- 基于显著的预测因素构建了一个名ogram.
主要成果:
- 单变量分析确定了与pCR相关的组织学,CEA水平,临床N阶段,CRM和NLR.
- 多变量分析证实了组织学,CEA水平和NLR作为PCR的独立预测因素.
- 开发的诺米图表表现出良好的预测性能,AUC为0.786.
结论:
- 组织学,CEA水平和NLR是LARC中对nCRT治疗反应的重要预测因素.
- 开发出来的诺姆图可以帮助对LARC患者进行个性化治疗计划.
- 准确预测pCR可以导致更有效的治疗策略和改善患者的治疗结果.
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