局部晚期原发性直肠癌患者接受新辅助化放疗后,柔性直肠乙状结肠镜检查和实验室检查结果对完全临床反应的预测价值:一项回顾性队列研究

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Alireza Hadizadeh, Hamed Kazemi-Khaledi, Mohammad-Sadegh Fazeli, Seyed-Mohsen Ahmadi-Tafti, Amir Keshvari, Reza Akbari-Asbagh, Mohammad-Reza Keramati, Alireza Kazemeini, Amir-Reza Fazeli, Behnam Behboudi, Mohammadamin Parsaei
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引用次数: 0

摘要

目的 直肠癌是全球第二大癌症死因。局部晚期直肠癌的标准治疗方法包括新辅助化放疗和全直肠系膜切除术(TME),但这两种治疗方法的发病率都很高。经过新辅助治疗后,三分之一的患者可获得病理完全反应(pCR),并有资格接受观察和等待疗法,而无需进行 TME。方法 收集了119例无远处转移的原发性局部晚期直肠癌患者的人口统计学、临床和内镜数据,这些患者在新辅助治疗结束后6-8周接受了内镜复查和TME检查。新辅助治疗后,TME 标本的组织学检查中没有肿瘤细胞被认为是 pCR。结果根据多变量逻辑回归分析,肿瘤边缘肿胀变平(p 值为 0.001,几率比为 100.605)成为直肠癌患者 pCR 的独立预测因子。此外,接收器操作特征曲线分析显示,术前较低的癌胚抗原和红细胞沉降率水平可预测 pCR,临界值分别为 2.15 纳克/毫升和 19.0 毫米/小时。这些因素为根据内窥镜和实验室检查结果选择保守治疗的候选者提供了一种潜在的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Predictive value of flexible proctosigmoidoscopy and laboratory findings for complete clinical responses after neoadjuvant chemoradiotherapy in patients with locally advanced primary rectal cancer: a retrospective cohort study

Predictive value of flexible proctosigmoidoscopy and laboratory findings for complete clinical responses after neoadjuvant chemoradiotherapy in patients with locally advanced primary rectal cancer: a retrospective cohort study

Purpose

Colorectal cancer is the second leading cause of cancer death worldwide. Standard treatments for locally advanced rectal cancer include neoadjuvant chemoradiotherapy and total mesorectal excision (TME), which are associated with significant morbidity. After neoadjuvant therapy, one-third of patients achieve a pathological complete response (pCR) and are eligible for a watch-and-wait approach without TME. The purpose of this study was to determine the potential predictors of pCR before surgery.

Methods

The demographic, clinical, and endoscopic data of 119 patients with primary locally advanced rectal cancer without distant metastasis who underwent restaging endoscopy and TME 6–8 weeks after the end of neoadjuvant therapy were collected. The absence of tumor cells in the histological examination of the TME specimen after neoadjuvant therapy was considered pCR. Binary logistic regression and receiver operating characteristic curves were utilized for analysis.

Results

According to the multivariate logistic regression analysis, flattening of marginal tumor swelling (p value < 0.001, odds ratio = 100.605) emerged as an independent predictor of pCR in rectal cancer patients. Additionally, receiver operating characteristic curve analysis revealed that lower preoperative carcinoembryonic antigen and erythrocyte sedimentation rate levels predict pCR, with cutoffs of 2.15 ng/ml and 19.0 mm/h, respectively.

Conclusion

Carcinoembryonic antigen and erythrocyte sedimentation rate, along with the presence of flattening of marginal tumor swelling, can predict pCR after neoadjuvant chemoradiotherapy in patients with primary rectal cancer. These factors offer a potential method for selecting candidates for conservative treatment based on endoscopic and laboratory findings.

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来源期刊
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.
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