DIAGNOSTICS OF LYMPHOGENIC METASTASIS IN PATIENTS WITH RECTAL CANCER BY COMBINING MRI WITH BLOOD CEA ASSESSMENT.

Q3 Medicine

Experimental oncology Pub Date : 2023-06-26 DOI:10.15407/exp-oncology.2023.01.099

S V Maliborska, V V Holotiuk, Y D Partykevich, I S Holotiuk

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引用次数: 0

Abstract

Aim: To improve the diagnostics of lymphogenic metastasis in patients with rectal cancer (RCa) by combining magnetic resonance imaging (MRI) with the blood carcinoembryonic antigen (CEA) level assessment.

Materials and methods: We have systematized and analyzed the results of the examination and treatment of 77 patients with stage II-III rectal adenocarcinoma (T2-3N0-2M0). Before the start of neoadjuvant treatment as well as 8 weeks after its completion, computed tomography (CT) and MRI were performed. We analyzed such prognostic criteria as the size, shape, and structure of lymph nodes as well as the patterns of contrast accumulation. As a prognostic marker, CEA levels in the blood of patients with RCa before surgical treatment were assessed.

Results: Radiological exams showed a rounded shape and heterogeneous structure to be the most informative for predicting metastatic lymph node damage, increasing the probability by 4.39 and 4.98 times, respectively. After neoadjuvant treatment, the percentage of positive histopathological reports on lymph node involvement decreased significantly to 21.6% (р ˂ 0.001). MRI showed 76% sensitivity and 48% specificity for assessing lymphogenic metastasis. CEA levels differed significantly between stages II and III (N1-2) (р ˂ 0.032) with a threshold value of 3.95 ng/ml.

Conclusions: In order to increase the effectiveness of the diagnosis of lymphogenic metastasis using radiological examination methods in RCa patients, such prognostic criteria as the round shape and heterogeneous structure of the lymph nodes and the threshold level of CEA should be considered.

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mri联合血cea评价对直肠癌淋巴源性转移的诊断价值。

目的:将磁共振成像(MRI)与血癌胚抗原(CEA)水平评估相结合，提高直肠癌(RCa)淋巴源性转移的诊断水平。材料与方法:我们对77例II-III期直肠腺癌(T2-3N0-2M0)的检查和治疗结果进行了系统整理和分析。在新辅助治疗开始前和治疗结束后8周，分别进行CT和MRI检查。我们分析了诸如淋巴结的大小，形状和结构以及造影剂积累模式等预后标准。作为预后指标，评估术前RCa患者血液中的CEA水平。结果:放射检查显示圆形和非均匀结构是预测转移性淋巴结损害的最重要信息，概率分别提高4.39倍和4.98倍。在新辅助治疗后，淋巴结受累的组织病理学阳性报告的百分比显著下降到21.6% (p < 0.001)。MRI对淋巴源性转移的敏感性为76%，特异性为48%。CEA水平在II期和III期(N1-2)之间差异显著(p < 0.05)，阈值为3.95 ng/ml。结论:为了提高影像学诊断RCa患者淋巴源性转移的有效性，应考虑淋巴结的圆形和异质性结构以及CEA阈值水平等预后标准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Experimental oncology Medicine-Oncology

CiteScore

1.40

自引率

0.00%

发文量

期刊介绍： The Experimental Oncology is an English-language journal that publishes review articles, original contributions, short communications, case reports and technical advances presenting new data in the field of experimental and fundamental oncology. Manuscripts should be written in English, contain original work, which has not been published or submitted for publication elsewhere. It also implies the transfer of the Copyright from the author to “Experimental Oncology”. No part of journal publications may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the prior permission of the publisher.