原发灶肿瘤体积对局部进展期直肠癌新辅助放化疗后病理完全反应的预测价值
发布时间：2018-11-18 19:26
【摘要】：目的:探讨用原发灶大体肿瘤体积(GTV)预测局部进展期直肠癌(LARC)患者行新辅助放化疗(nCRT)后病理完全缓解(pCR)可行性。方法:回顾中南大学湘雅医院胃肠外科2009年3月—2015年12月行nCRT后予以根治性切除的LRAC患者107例资料,分析LARC患者行nCRT后到达pCR的临床预测因素,免疫组化检测患者肿瘤组织中直肠癌干细胞标志物CD133的表达,并分析原发灶GTV与直肠癌干细胞的关系。结果:107例LARC患者中,25例(23.36%)获pCR。LARC患者的原发灶GTV与肿瘤原发灶沿肠纵轴长度(r=0.580,P0.001)及肿瘤原发灶最大径(r=0.608,P0.001)均成正相关,但pCR患者与非pCR患者间仅在原发灶GTV(P=0.024)、nCRT前血清CEA水平(P=0.020)及多药化疗方案(P=0.05)方面存在明显差异。ROC曲线确定原发灶GTV判断肿瘤反应的最佳截点值为70.29 cm~3。Logistic回归分析显示,小原发灶GTV(70 cm~3)(P=0.019)与多药联合化疗(P=0.032)LRAC患者nCRT后pCR的独立促进因素;大原发灶GTV(≥70 cm~3)的患者肿瘤组织CD133表达量明显高于小原发灶GTV(70 cm~3)的患者(P=0.017)。结论:原发灶GTV可作为LARC患者行nCRT后pCR的独立预测因素,原发灶GTV大者pCR率低,原因可能部分与原发灶GTV越大肿瘤中的肿瘤干细胞量越高有关。
[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，
本文编号：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，
本文编号：2340959
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