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Eur Radiol:MRI诊断直肠癌术前化疗前后壁外静脉浸润的诊断和预后价值

2017-08-16 shaosai MedSci原创

直肠癌的病因目前仍不十分清楚,其发病与社会环境、饮食习惯、遗传因素等有关。直肠息肉也是直肠癌的高危因素。目前基本公认的是动物脂肪和蛋白质摄入过高,食物纤维摄入不足是直肠癌发生的高危因素。本研究旨在评价MRI鉴别直肠癌患者术前化疗壁外静脉浸润(EMVI)的诊断能力及其预后意义,并将结果发表在Eur Radiol上。

直肠癌的病因目前仍不十分清楚,其发病与社会环境、饮食习惯、遗传因素等有关。直肠息肉也是直肠癌的高危因素。目前基本公认的是动物脂肪和蛋白质摄入过高,食物纤维摄入不足是直肠癌发生的高危因素。本研究旨在评价MRI鉴别直肠癌患者术前化疗壁外静脉浸润(EMVI)的诊断能力及其预后意义,并将结果发表在Eur Radiol上。

本研究共纳入了2008-2010的200例行术前CRT并行手术治疗的直肠癌患者。两名放射科医生独立分析CRT前后的MRI图像。以病理EMVI为参考标准,探究pre-CRT MR-EMVI (MR-EMVI) 和 post-CRT MR-EMVI (yMR-EMVI)的诊断能力。评价MRI表现和病人预后,如无病生存(DFS)和整体生存(OS)的相关性。另外,亚组分析MR- or yMR-EMVI阳性的患者来确定MRI表现有EMVI的严重程度在患者预后的重要性。

结果为,yMR-EMVI的敏感性和特异性分别为76.19%、79.75% (AUC: 0.830)。在单变量分析中,yMR-EMVI是DFS (P = 0.027)唯一显着相关的MRI因素。yMR-EMVI (+)的患者平均DFS要明显少于yMR-EMVI (-)的患者:57.56 月vs. 72.46月。

本研究表明,yMR-EMVI具有良好的诊断能力。yMR-EMVI是唯一一个与EMVI相关的MRI因素,在单变量分析中与DFS具有相关性;然而,在多变量分析中并无显着相关性。

原始出处:


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    2018-07-16 fusion
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    2017-08-17 明天会更好!

    看看学习一下知识!

    0

  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLANEL7Sww3HicKsN9aribicAmGGWXOIMEiaZ1iadgZg9RibjqSwIKUS8gSPib2NwTVg2zVvVJhdP3BkuDIl/0, createdBy=944d1605392, createdName=shaosai, createdTime=Thu Aug 17 09:37:01 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234349, encodeId=f305234349e6, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Thu Aug 17 08:35:24 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234341, encodeId=86f523434106, content=文章很好,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Thu Aug 17 08:29:58 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234321, encodeId=bc65234321a2, content=好好学习看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Aug 17 07:53:08 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234283, encodeId=a1ce2342838f, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Thu Aug 17 07:00:24 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234267, encodeId=df7723426eeb, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Aug 17 06:45:28 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234234, encodeId=f28e23423433, content=学习了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Wed Aug 16 23:50:04 CST 2017, time=2017-08-16, status=1, ipAttribution=)]
    2017-08-17 shaosai

    好好学习,谢谢分享!

    0

  5. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Thu Aug 17 07:00:24 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234267, encodeId=df7723426eeb, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Aug 17 06:45:28 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234234, encodeId=f28e23423433, content=学习了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Wed Aug 16 23:50:04 CST 2017, time=2017-08-16, status=1, ipAttribution=)]
    2017-08-17 李东泽

    很好,不错,以后会多学习

    0

  6. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Thu Aug 17 07:00:24 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234267, encodeId=df7723426eeb, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Aug 17 06:45:28 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234234, encodeId=f28e23423433, content=学习了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Wed Aug 16 23:50:04 CST 2017, time=2017-08-16, status=1, ipAttribution=)]
    2017-08-17 1e10c84am36(暂无匿称)

    文章很好,值得分享

    0

  7. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Thu Aug 17 07:00:24 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234267, encodeId=df7723426eeb, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Aug 17 06:45:28 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234234, encodeId=f28e23423433, content=学习了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Wed Aug 16 23:50:04 CST 2017, time=2017-08-16, status=1, ipAttribution=)]
    2017-08-17 忠诚向上

    好好学习看看

    0

  8. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Thu Aug 17 07:00:24 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234267, encodeId=df7723426eeb, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Aug 17 06:45:28 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234234, encodeId=f28e23423433, content=学习了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Wed Aug 16 23:50:04 CST 2017, time=2017-08-16, status=1, ipAttribution=)]
    2017-08-17 刘煜

    学习了谢谢分享

    0

  9. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Thu Aug 17 08:29:58 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234321, encodeId=bc65234321a2, content=好好学习看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Aug 17 07:53:08 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234283, encodeId=a1ce2342838f, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Thu Aug 17 07:00:24 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234267, encodeId=df7723426eeb, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Aug 17 06:45:28 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234234, encodeId=f28e23423433, content=学习了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Wed Aug 16 23:50:04 CST 2017, time=2017-08-16, status=1, ipAttribution=)]
    2017-08-17 龙胆草

    学习谢谢分享

    0

  10. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Thu Aug 17 07:00:24 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234267, encodeId=df7723426eeb, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Aug 17 06:45:28 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=234234, encodeId=f28e23423433, content=学习了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Wed Aug 16 23:50:04 CST 2017, time=2017-08-16, status=1, ipAttribution=)]
    2017-08-16 林3301

    学习了解一下

    0

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生物单克隆抗体联合化疗能为晚期或转移性结直肠癌带来获益,但哪种生物疗法是最佳选择呢?2017年6月,发表在《JAMA》的一项研究显示,在未治疗的KRAS野生型晚期或转移性结直肠癌患者中,西妥昔单抗 vs 贝伐珠单抗联合化疗作为初始治疗没有明显差异。

Oncotarget:免疫浸润检测有利于预测直肠癌术前放化疗反应性

直肠癌是消化道最常见的恶性肿瘤之一,直肠癌位置低,其位置深入盆腔,解剖关系复杂,手术不易彻底,术后复发率高,我国直肠癌发病年龄中位数在45岁左右,青年人发病率有升高的趋势。

Cancer:有些80-90多岁的直肠癌患者没有接受治疗

根据7月31日在“癌症”网络上发表的一项研究,大约15%的80-89岁的人和IIAG / II期直肠腺癌的90多岁的然未接受治疗。

Nutrition:警示!“炎症性饮食”或增加结直肠癌风险

慢性炎症可造成癌症。饮食通过改变炎症生物标志物的循环水平而在调节慢性炎症中起到重要作用。2017年6月,发表在《Nutrition》的一项在加拿大纽芬兰进行的基于人群的病例对照研究调查了炎症性饮食和结直肠癌风险之间的相关性。

Lancet Oncol:TAS-102 联合贝伐单抗有效治疗难治性转移性结直肠癌

日本的Kuboki教授在The Lancet Oncology杂志上发表研究,评估了TAS-102 联合贝伐单抗治疗标准治疗难治性或不耐受的转移性结直肠癌,结果表明两药的联合具有抗肿瘤协同作用,且安全性可控。

Cochrane Db Syst Rev:氟尿嘧啶:口服用药和静脉给药,疗效有区别吗?

氟尿嘧啶类药物是结直肠癌(CRC)治疗的必要组成部分,患者通常更愿意选择口服片剂,因其安全、使用方便,但口服与静脉(IV)剂型的作用真的完全相同吗?这项研究发现CRC无论是治愈性治疗还是姑息性治疗时,IV和口服氟尿嘧啶的作用并不完全相同。

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