结构化磁共振成像评估改善了新辅助化疗后直肠癌病理完整反应的诊断
Oncology research and treatment
|September 5, 2025
概括
在新辅助化疗 (nCRT) 后准确预测直肠癌的病理完整反应 (pCR) 是至关重要的. 磁共振成像瘤回归度 (mrTRG) 是PCR的强有力的预测指标,应经常使用.
科学领域:
- 癌症学
- 放射学
- 胃肠病学
背景情况:
- 在新辅助化学放射治疗 (nCRT) 后,精确预测病理完整反应 (pCR) 对于选择患者进行非手术治疗至关重要.
- 优化PCR预测的诊断工具是一个重大的临床挑战.
研究的目的:
- 评估各种诊断工具的预测性能,特别是磁共振成像瘤回归等级 (mrTRG),用于接受nCRT治疗的直肠癌患者.
- 开发和验证PCR的多变量预测模型.
主要方法:
- 从2010年至2020年期间接受治疗的261名直肠癌患者的临床,实验室,内镜和放射学数据的回顾性收集.
- 使用结构化报告模板对nCRT前后MRI进行评估,并由两名独立放射科医生对mrTRG进行评估.
- 用曲线下的面积 (AUC) 来进行模型开发和性能评估的单变量和L1惩罚后勤回归.
主要成果:
- 单变量分析确定了nCRT后的放射性T阶段,mrTRG和内镜反应是pCR的显著预测因素.
- mrTRG显示出最高的预测准确度,AUC为0.77和相当大的读者之间的一致性 (kappa=0.71).
- 多变量模型包含8个nCRT前后参数,其明显AUC为0.84和交叉验证的AUC为0.73.
结论:
- 通过MRI评估的治疗反应,特别是mrTRG,是nCRT后直肠癌中pCR的强有力的预测指标.
- 应将mrTRG纳入接受nCRT的直肠癌患者的常规评估,以指导治疗决策和非手术治疗的患者选择.
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