The Optimal Application of Transrectal Ultrasound in Staging of Rectal Cancer Following Neoadjuvant Therapy: A Pragmatic Study for Accuracy Investigation.
The Optimal Application of Transrectal Ultrasound in Staging of Rectal Cancer Following Neoadjuvant Therapy: A Pragmatic Study for Accuracy Investigation.
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经直肠超声在新辅助治疗后直肠癌分期中的最佳应用：准确性调查的实用研究
DOI：
10.7150/jca.22661
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发表时间：
2018
影响因子：
3.9
通讯作者：
Yuan Y
中科院分区：
文献类型：
--
作者：
Ren Y;Ye J;Wang Y;Xiong W;Xu J;He Y;Cai S;Tan M;Yuan Y
背景：经直肠超声（TRUS）是一种具有成本效益的直肠癌术前评估方法。然而，TRUS分期的准确性是否与肿瘤位置相关仍不清楚。本研究旨在探讨两者之间的关系，并确定TRUS在直肠癌再分期中的最佳应用。方法：回顾性分析2005 ~ 2011年直肠癌TRUS患者的资料。根据肛缘以上肿瘤累及直肠节段（SEG）分为5组：SEG I 1 ~ 3cm， II 3 ~ 6cm, III 6 ~ 9cm, IV 9 ~ 12cm, V 12 ~ 16cm。比较超声与病理分期对肿瘤分期的准确性和远期预后。结果：共纳入219例患者，其中SEGⅰ期55例（25.1%），SEGⅱ期123例（56.2%），SEGⅲ期32例（14.6%），SEGⅳ期4例（1.8%），SEGⅴ期5例（2.3%）。CT对TRUS分期的总体准确率明显优于临床分期（64.8% vs. 34.7%， P<0.001），超声T期和N期准确率分别为70.3%和82.2%。当肿瘤位于SEG II时，TRUS的准确性达到峰值。TRUS与病理分期的5年总生存率无显著差异。cox回归分析显示，高CEA水平和肿瘤位置是不准确分期的危险因素。结论：TRUS对直肠癌新辅助治疗后的再分期检查仍有价值。对于肛门边缘以上3-6cm的直肠癌，TRUS的应用最为理想。
Background: Transrectal ultrasound (TRUS) is a cost-effective test for preoperative assessment of rectal cancer. However, whether the accuracy of TRUS staging is correlated with tumor location remains obscured. This study is designed to explore their relationship and confirm an optimal application of TRUS in rectal cancer restaging. Methods: From 2005 to 2011, rectal cancer patients with TRUS data were retrospectively reviewed. Patients were divided into five groups according to tumor-involved rectal segment (SEG) above the anal verge: SEG I 1-3cm, II 3-6cm, III 6-9cm, IV 9-12cm, and V 12-16cm. The accuracy and long-term outcomes of tumor staging were compared between ultrasonographic and pathological stages. Results: 219 patients were included, with 55 (25.1%) in SEG I, 123 (56.2%) in SEG II, 32 (14.6%) in SEG III, 4 (1.8%) in SEG IV and 5 (2.3%) in SEG V. The overall accuracy of TRUS staging was remarkably superior to clinical staging by CT (64.8% vs. 34.7%, P<0.001), with 70.3% and 82.2% for ultrasonographic T and N stages respectively. The accuracy of TRUS reached its peak value when tumors were located in SEG II. The 5-year overall survival had no significant difference between TRUS and pathology staging for all stages. A cox regression analysis indicated that high levels of CEA and tumor location were risk factors of inaccurate staging. Conclusions: TRUS is still a valuable examination for restaging of rectal cancer after neoadjuvant therapy. The application of TRUS would be optimal for rectal cancer located 3-6cm above the anal verge.
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DOI：
10.1111/j.1440-1746.2005.03927.x
发表时间：
2006-02-01
影响因子：
4.1
作者：
Maor, Y;Nadler, M;Avidan, B
通讯作者：
Avidan, B
影响因子：
2.8
作者：
RIFKIN, MD;WECHSLER, RJ
通讯作者：
WECHSLER, RJ
影响因子：
2.8
作者：
Kwok, H;Bissett, IP;Hill, GL
通讯作者：
Hill, GL
DOI：
10.1016/j.jamcollsurg.2008.01.002
发表时间：
2008-07-01
影响因子：
5.2
作者：
Huh, Jung Wook;Park, Yoon Ah;Sohn, Seung-Kook
通讯作者：
Sohn, Seung-Kook
DOI：
10.1007/s00464-008-0037-3
发表时间：
2008-11-01
影响因子：
3.1
作者：
Radovanovic, Zoran;Breberina, M.;Radovanovic, D.
通讯作者：
Radovanovic, D.