Investigating the prognostic value of lateral mesorectum using preoperative high-resolution MRI in patients with rectal cancer.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

International Journal of Colorectal Disease Pub Date : 2025-04-02 DOI:10.1007/s00384-025-04871-4

Siyuan Jiang, Qiaoling Chen, Shuqin Zang, Haidi Lu, Shiyu Ma, Fangying Chen, Wei Zhang, Chengwei Shao, Fu Shen

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引用次数: 0

Abstract

Background: To explore the lateral mesorectum structures and develop a nomogram model for predicting the prognosis of rectal cancer (RC) patients using preoperative high-resolution magnetic resonance imaging (MRI).

Methods: Patients who underwent radical resection of RC in our hospital from January 2017 to December 2018 were retrospectively analyzed. Imaging data and postoperative 3-year prognosis data of patients were collected. The lateral mesorectum was observed, and related parameters were investigated: lateral interruption of the mesorectal fascia (LI-MRF), type of the middle rectal artery (MRA), and the maximum diameter of the MRA. The impact of lateral mesorectum parameters on prognosis was determined using Cox analysis and Kaplan-Meier (KM) survival curves. A nomogram combining lateral mesorectum parameters with clinical data was constructed and its predictive performance was validated.

Results: A total of 260 patients were included in this study. In preoperative high-resolution MRI, LI-MRF and MRA were observed bilaterally in all patients. Multivariate Cox regression analysis showed that the maximum diameter of the right MRA (P = 0.001) and right LI-MRF (P = 0.016) were predictive factors for postoperative 3-year overall survival (OS). Additionally, gender (P = 0.015), mrT stage (P = 0.025), and the maximum diameter of the right MRA (P = 0.002) were predictive factors for postoperative 3-year disease-free survival (DFS). The concordance indexes (C-index) of the predictive nomogram were 0.737 for OS and 0.685 for DFS.

Conclusion: Preoperative high-resolution MRI revealed that the lateral mesorectum and MRA were inherent. The right LI-MRF and the maximum diameter of the right MRA were risk factors for poor postoperative survival in RC patients.

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应用术前高分辨率MRI探讨直肠癌患者侧系直肠的预后价值。

背景：探讨直肠癌（RC）患者术前高分辨率磁共振成像（MRI）的直肠外系直肠结构，建立预测预后的nomogram模型。方法：回顾性分析2017年1月至2018年12月在我院行根治性癌切除术的患者。收集患者影像学资料及术后3年预后资料。观察外侧直肠系膜，并观察相关参数：直肠系膜筋膜外侧中断（LI-MRF）、直肠中动脉类型（MRA）、MRA最大直径。采用Cox分析和Kaplan-Meier （KM）生存曲线确定外侧系直肠参数对预后的影响。构建了结合侧系直肠系膜参数与临床数据的nomogram，并对其预测效果进行了验证。结果：本研究共纳入260例患者。术前高分辨率MRI中，所有患者均观察到双侧LI-MRF和MRA。多因素Cox回归分析显示，右侧MRA最大直径（P = 0.001）和右侧LI-MRF （P = 0.016）是术后3年总生存（OS）的预测因素。此外，性别（P = 0.015）、mrT分期（P = 0.025）和右侧MRA最大直径（P = 0.002）是术后3年无病生存（DFS）的预测因素。OS预测模态图的一致性指数（c指数）为0.737，DFS预测模态图的一致性指数为0.685。结论：术前高分辨率MRI显示外侧直肠系膜和MRA是固有的。右LI-MRF和右MRA最大直径是RC患者术后生存不良的危险因素。

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

International Journal of Colorectal Disease 医学-外科

CiteScore

4.90

自引率

3.60%

发文量

206

审稿时长

3-8 weeks

期刊介绍： The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.