Prognostic significance of magnetic resonance imaging-detected extramural vascular invasion in rectal cancer
Prognostic significance of magnetic resonance imaging-detected extramural vascular invasion in rectal cancer
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DOI：
10.1002/bjs.5917
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发表时间：
2008-02-01
影响因子：
9.6
通讯作者：
Brown, G.
中科院分区：
文献类型：
--
作者：
Smith, N. J.;Barbachano, Y.;Brown, G.
背景：肠壁外血管浸润（EMVI）是结直肠癌预后不良的特征。磁共振成像（MRI）在检测EMVI和预测无复发生存期（RFS）的准确性进行了回顾性比较与组织学的参考standard.Methods：术前磁共振图像诊断为直肠癌和乙状结肠癌患者进行了审查，并分配一个MRI-EMVI评分（范围0至4）。比较了组织学和临床outcome.Results：一些142例中位随访时间为3.3（范围0.9-5.7）年的患者进行了审查。组织学。四分之一的患者报告了EMVI。MRI检测94例初次手术患者EMVI的敏感性和特异性分别为62%和88%。在单变量分析中，MRI-EMVI评分为3-4的患者3年RFS为35%，而评分为0-2的患者为74（P < 0.001），与组织学EMVI阳性和阴性患者的值相似结论：高MRI-EMVI评分有助于预测疾病复发。
Background: Extramural vascular invasion (EMVI) is a poor prognostic feature in colorectal cancer. The accuracy of magnetic resonance imaging (MRI) in detecting EMVI and predicting relapse-free survival (RFS) was compared retrospectively with the histological reference standard.Methods: Preoperative magnetic resonance images from patients diagnosed with rectal and sigmoid cancer were reviewed and an MRI-EMVI score (range 0 to 4) was assigned. Comparison was made with histology and clinical outcome.Results: Some 142 patients with a median follow-up of 3.3 (range 0.9-5.7) years were reviewed. Histological. EMVI was reported in a quarter of patients. The sensitivity and specificity of MRI detection of EMVI in 94 patients undergoing primary surgery were 62 and 88 per cent respectively. On univariable analysis, RFS at 3 years was 35 per cent for patients with an MRI-EMVI score of 3-4, compared with 74 per cent for those with a score of 0-2 (P < 0.001), similar to values in patients with positive and negative histological EMVI status respectively (34 versus 73.7 per cent; P < 0.001).Conclusion: High MRI-EMVI scores may help in predicting disease relapse.