结直肠癌患者的病理完整反应:病理和临床阶段与瘤结果之间的相关性
Ana Grigoraș1,2, Dragoș-Viorel Scripcariu1,2, Ionuț Huțanu1,2
1Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Cancers
|January 28, 2026
概括
磁共振成像 (MRI) 在预测直肠癌新辅助疗法后病理完整反应 (pCR) 的准确性有限. 实现pCR是有利的,但不能消除转移风险,需要持续监测.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 手术瘤学手术瘤学
背景情况:
- 结直肠癌的治疗策略以瘤阶段和新辅助疗法反应为指导.
- 通过MRI准确评估瘤回归,可以为个性化管理提供信息,包括非手术方法.
- 预测病理完整反应 (pCR) 对于优化直肠癌治疗至关重要.
研究的目的:
- 评估直肠癌患者临床分期和病理完整反应 (pCR) 之间的相关性.
- 评估MRI在确定新辅助治疗后瘤反应的准确性.
- 探索pCR与直肠癌中的临床变量之间的关联.
主要方法:
- 对1693名接受新辅助疗法和彻底切除治疗的直肠癌患者的回顾性分析.
- 使用MRI评估临床阶段和瘤反应,重点关注T和N阶段.
- pCR定义为缺少瘤细胞在组织病理学上;与临床变量相关的研究.
主要成果:
- 在接受新辅助治疗的783名患者中,62名 (7.92%) 实现了pCR.
- 治疗前的阶段主要是cT3和cN2b.
- 在治疗后的MRI显示了32.3%的患者的完整瘤反应 (T0) 和54.8%的患者的节点下降到N0.
- 核磁共振扫描显示,临床评估与病理结局之间存在有限的相关性;9.6%的人患有远程转移,没有局部复发.
结论:
- 磁力共振成像对于手术前评估有价值,但在预测直肠癌的pCR时的准确性有限.
- pCR是一个积极的预后指标,但并不否定远程转移的风险.
- 个性化监测和管理对于优化获得pCR的直肠癌患者的治疗结果至关重要.
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