原發(fā)灶腫瘤體積對局部進展期直腸癌新輔助放化療后病理完全反應的預測價值
發(fā)布時間：2018-11-18 19:26
【摘要】：目的:探討用原發(fā)灶大體腫瘤體積(GTV)預測局部進展期直腸癌(LARC)患者行新輔助放化療(nCRT)后病理完全緩解(pCR)可行性。方法:回顧中南大學湘雅醫(yī)院胃腸外科2009年3月—2015年12月行nCRT后予以根治性切除的LRAC患者107例資料,分析LARC患者行nCRT后到達pCR的臨床預測因素,免疫組化檢測患者腫瘤組織中直腸癌干細胞標志物CD133的表達,并分析原發(fā)灶GTV與直腸癌干細胞的關(guān)系。結(jié)果:107例LARC患者中,25例(23.36%)獲pCR。LARC患者的原發(fā)灶GTV與腫瘤原發(fā)灶沿腸縱軸長度(r=0.580,P0.001)及腫瘤原發(fā)灶最大徑(r=0.608,P0.001)均成正相關(guān),但pCR患者與非pCR患者間僅在原發(fā)灶GTV(P=0.024)、nCRT前血清CEA水平(P=0.020)及多藥化療方案(P=0.05)方面存在明顯差異。ROC曲線確定原發(fā)灶GTV判斷腫瘤反應的最佳截點值為70.29 cm~3。Logistic回歸分析顯示,小原發(fā)灶GTV(70 cm~3)(P=0.019)與多藥聯(lián)合化療(P=0.032)LRAC患者nCRT后pCR的獨立促進因素;大原發(fā)灶GTV(≥70 cm~3)的患者腫瘤組織CD133表達量明顯高于小原發(fā)灶GTV(70 cm~3)的患者(P=0.017)。結(jié)論:原發(fā)灶GTV可作為LARC患者行nCRT后pCR的獨立預測因素,原發(fā)灶GTV大者pCR率低,原因可能部分與原發(fā)灶GTV越大腫瘤中的腫瘤干細胞量越高有關(guān)。
[Abstract]:Objective: to evaluate the feasibility of predicting the complete remission of (pCR) after neoadjuvant chemoradiotherapy with neoadjuvant chemoradiotherapy (nCRT) in patients with local advanced rectal cancer (LARC) by using gross tumor volume (GTV) of primary tumor. Methods: the data of 107 patients with LRAC undergoing radical resection after nCRT from March 2009 to December 2015 in Xiangya Hospital of Central South University were reviewed. The clinical predictors of pCR after nCRT were analyzed. The expression of tumor stem cell marker CD133 was detected by immunohistochemistry, and the relationship between primary tumor GTV and rectal cancer stem cell was analyzed. Results: of the 107 patients with LARC, 25 (23.36%) had a positive correlation with the length of the primary tumor along the longitudinal axis of the intestine (r = 0.580) and the maximum diameter of the primary tumor (r = 0.608, P 0.001). But between pCR patients and non-pCR patients, only primary GTV (P0. 024), There were significant differences in serum CEA level (P0. 020) and multidrug chemotherapy regimen (P0. 05) before nCRT. The ROC curve was used to determine the best cut-off point of the primary tumor GTV for judging tumor response. The regression analysis of 70.29 cm~3.Logistic showed that there was no significant difference in the level of serum CEA (P0. 020) and multidrug chemotherapy regimen (P0. 05). The independent promotive factors of pCR after nCRT in patients with small primary GTV (70 cm~3) and multidrug combined chemotherapy (P0. 032) LRAC; The expression of CD133 in tumor tissues of patients with large primary GTV (鈮，
本文編號：2340959
[Abstract]:Objective: to evaluate the feasibility of predicting the complete remission of (pCR) after neoadjuvant chemoradiotherapy with neoadjuvant chemoradiotherapy (nCRT) in patients with local advanced rectal cancer (LARC) by using gross tumor volume (GTV) of primary tumor. Methods: the data of 107 patients with LRAC undergoing radical resection after nCRT from March 2009 to December 2015 in Xiangya Hospital of Central South University were reviewed. The clinical predictors of pCR after nCRT were analyzed. The expression of tumor stem cell marker CD133 was detected by immunohistochemistry, and the relationship between primary tumor GTV and rectal cancer stem cell was analyzed. Results: of the 107 patients with LARC, 25 (23.36%) had a positive correlation with the length of the primary tumor along the longitudinal axis of the intestine (r = 0.580) and the maximum diameter of the primary tumor (r = 0.608, P 0.001). But between pCR patients and non-pCR patients, only primary GTV (P0. 024), There were significant differences in serum CEA level (P0. 020) and multidrug chemotherapy regimen (P0. 05) before nCRT. The ROC curve was used to determine the best cut-off point of the primary tumor GTV for judging tumor response. The regression analysis of 70.29 cm~3.Logistic showed that there was no significant difference in the level of serum CEA (P0. 020) and multidrug chemotherapy regimen (P0. 05). The independent promotive factors of pCR after nCRT in patients with small primary GTV (70 cm~3) and multidrug combined chemotherapy (P0. 032) LRAC; The expression of CD133 in tumor tissues of patients with large primary GTV (鈮，
本文編號：2340959
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