摘要
目的探讨局部晚期直肠癌患者接受新辅助放化疗(nCRT)后达病理完全缓解(pCR)的关联因素。方法回顾性分析2017-06-01—2019-04-10福建医科大学附属协和医院305例确诊为局部晚期直肠癌患者临床资料,所有患者均接受nCRT及根治性手术,80例术后达pCR为病例组,225例未达pCR为对照组。采用病例对照研究分析方法,以二元Logistic回归模型分析与pCR有关联的影响因素。结果女性(35.3%)较男性(21.7%)表现出更高的pCR率,OR=1.923,95%CI为1.102~3.356,P=0.021;且nCRT后乳酸脱氢酶(LDH)水平升高的患者pCR率较LDH水平正常组的患者高(45.7%vs 23.7%),OR=2.386,95%CI为1.109~5.131,P=0.026。而年龄、肿瘤距肛缘距离、nCRT前T分期、N分期、化疗方案、癌胚抗原、血红蛋白、中性粒细胞数、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、肌酐水平及nCRT前LDH水平与是否pCR均无统计学意义的关联。结论女性及nCRT后的血清LDH水平升高是局部晚期直肠癌患者接受nCRT后达pCR的关联因素。
Objective To explore the related factors of pathologic complete response(pCR)in locally advanced rectal cancer receiving neoadjuvant chemoradiotherapy(nCRT).Methods From June 1 st 2017 to April 10 th 2019,305 patients with locally advanced rectal cancer were enrolled in the study.All patients received nCRT followed by radical surgery.The case-control study included 80 case subjects who achieved pCR and 225 control subjects who did not achieve pCR.The binary logistic regression model was used to analyze the factors associated with pCR.Results Female patients showed a higher pCR rate than males(35.3%vs 21.7%,OR=1.923,95%CI:1.102-3.356,P=0.021),and the pCR rate among patients with elevated post-nCRT LDH was significantly higher than patients with normal post-nCRT LDH(45.7%vs 23.7%,OR=2.386,95%CI:1.109-5.131,P=0.026).However,age,distance from the anal verge,clinical T stage,clinical N stage,chemotherapy regimen,carcinoembryonic antigen,hemoglobin,neutrophil count,alanine aminotransferase,aspartate aminotransferase and creatinine were not statistically associated with pCR.Conclusion Female and elevated post-nCRT serum LDH level are the related factors of pCR following nCRT in locally advanced rectal cancer.
作者
陈朱虹
徐本华
CHEN Zhu-hong;XU Ben-hua(Department of Radiation Oncology,Fujian Medical University Union Hospital,Fuzhou 350001,China;Department of Radiation Oncology,Third Affiliated Hospital of Fujian Medical University,Fuzhou 350001,China;Fujian Medical University,Fuzhou 350001,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2022年第4期296-301,共6页
Chinese Journal of Cancer Prevention and Treatment
基金
福建省医学创新课题(2021CXA011)
关键词
直肠癌
新辅助放化疗
病理完全缓解
乳酸脱氢酶
血液生化标志物
rectal cancer
neoadjuvant chemoradiotherapy
pathologic complete response
lactate dehydrogenase
biomarker
