Role of barium enema examination for the diagnosis of submucosal invasion depth in T1 colorectal cancers.
Role of barium enema examination for the diagnosis of submucosal invasion depth in T1 colorectal cancers.
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DOI：
10.1186/s40644-021-00437-z
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发表时间：
2021-12-07
期刊：
影响因子：
--
通讯作者：
Matsumoto T
中科院分区：
文献类型：
--
作者：
Kawasaki K;Torisu T;Nagahata T;Esaki M;Kurahara K;Eizuka M;Tanaka Y;Fujiwara M;Kawatoko S;Oshiro Y;Yamada S;Ikegami K;Fujioka S;Fuyuno Y;Matsuno Y;Umeno J;Moriyama T;Kitazono T;Sugai T;Matsumoto T
黏膜下浸润性结直肠癌(T1-CRC)的手术指征取决于术前对肿瘤侵犯深度的诊断。本研究的目的是评估大肠癌的钡灌肠检查(BE)剖面图和粘膜下(SM)侵袭深度之间的关系。我们回顾了从2008年到2019年诊断的145例T1-CRC的X线和内窥镜表现。我们测量了对应于CRC的BE剖面图下的水平和垂直刚性宽度，并将其值与SM侵袭深度进行比较。水平刚性定义为水平长度，垂直刚性定义为每个靶区对应的钡缺损处的垂直宽度。通过对受试者工作特征曲线的分析，计算出预测SM侵袭的最合适的临界值≥为1.8 mm。水平刚性(r = 0.626，P <； 0.0 5)和垂直刚性(r = 0.482，P <； 0.0 5)与SM侵袭深度显著相关。预测SM侵袭深度 ≥ 1.8 mm时，水平刚性为4.5 mm，准确率为80.7%；垂直刚性为0.7 mm，准确率为77.9%。当采用这些临界值时，淋巴管侵犯的发生率有显著差异(水平僵硬43.2%对17.5%，P <； 0.005)。在T1-CRC中，BE剖面图下的水平和垂直刚性值与SM侵袭深度相关。尽管刚性系数对预测SM侵犯深度 ≥ 1.8 mm的准确性不高，但水平刚性系数可以预测淋巴管的侵犯，从而为治疗决策提供帮助。
The indication for endoscopic resection for submucosally invasive colorectal cancer (T1-CRC) depends on the preoperative diagnosis of invasion depth. The aim of this investigation was to evaluate the association between barium enema examination (BE) profile views and depth of submucosal (SM) invasion in CRCs. We reviewed the radiographic and endoscopic findings of 145 T1-CRCs diagnosed from 2008 to 2019. We measured the widths of horizontal and vertical rigidity under a BE profile view corresponding to CRC and compared the values with SM invasion depth. Horizontal rigidity was defined as the horizontal length and vertical rigidity as the vertical width of the barium defect corresponding to each target lesion. The most appropriate cut-off values for predicting SM invasion ≥1.8 mm were calculated by receiver operating characteristic curve analysis. Values of horizontal rigidity (r = 0.626, P < 0.05) and vertical rigidity (r = 0.482, P < 0.05) correlated significantly with SM invasion depth. The most appropriate cut-off values for the prediction of SM invasion depth ≥ 1.8 mm were 4.5 mm for horizontal rigidity, with an accuracy of 80.7%; and 0.7 mm for vertical rigidity, with an accuracy of 77.9%. The prevalence of lympho-vascular invasion was significantly different when those cut-off values were applied (43.2% vs. 17.5% for horizontal rigidity, P < 0.005). In T1-CRC, values of horizontal and vertical rigidities under a BE profile view were correlated with SM invasion depth. While the accuracy of the rigidities for the prediction of SM invasion depth ≥ 1.8 mm was not high, horizontal rigidity may be predictive of lympho-vascular invasion, thus aiding in therapeutic decision-making.
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作者：
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