直腸癌術前分期策略_《中國普外基礎與臨床雜志》

作者：

楊靚 ¹ , 汪曉東 ² , 秦昌龍 ¹ , 李立 ²

1.四川大學華西臨床醫學院/華西醫院(成都610041);;
2.四川大學華西醫院肛腸外科（成都610041）;

關鍵詞：

直腸腫瘤術前分期多模式術前評估經直腸超聲計算機斷層掃描技術磁共振成像多學科協作

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　總結直腸癌術前分期策略的研究進展。
方法　對有關直腸癌術前分期方法的文獻進行綜述，對新近提出的多模式術前評估（multimodal preoperative evaluation，MPE）系統的相關資料進行重點總結。
結果　恰當選擇目前存在的方法在直腸癌T分期及M分期上可以取得較高的準確性，但都不能對淋巴結轉移進行準確評估。在多學科協作診治模式下，采用MPE系統，即聯合經直腸超聲、計算機斷層掃描技術和血清淀粉樣蛋白A評估直腸癌，可取得目前較為準確的術前分期。
結論　MPE系統評估直腸癌術前分期具有良好的臨床應用前景。

引用本文： 楊靚,汪曉東,秦昌龍,李立. 直腸癌術前分期策略. 中國普外基礎與臨床雜志, 2009, 16(9): 714-717. doi: 復制

1.	汪曉東, 宋歡, 盧聰, 等. 骨盆測量在直腸癌手術中的應用進展 [Ｊ]. 醫學與哲學, 2009; 30(4): 45-46.
2.	Thoeni RF. Colorectal cancer: cross-sectional imaging for staging of primary tumor and detection of local recurrence [Ｊ]. AJR Am J Roentgenol, 1991; 156(5): 909-915.
3.	Rotte KH, Klühs L, Kleinau H, et al. Computed tomography and endosonography in the preoperative staging of rectal carcinoma [Ｊ]. Eur J Radiol, 1989; 9(3): 187-190.
4.	Kim NK, Kim MJ, Yun SH, et al. Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer [Ｊ]. Dis Colon Rectum, 1999; 42(6): 770-775.
5.	Gollub MJ, Schwartz LH, Akhurst T. Update on colorectal cancer imaging [Ｊ]. Radiol Clin North Am, 2007; 45(1): 85-118.
6.	Hodgman CG, MacCarty RL, Wolff BG, et al. Preoperative staging of rectal carcinoma by computed tomography and 0.15 T magnetic resonance imaging. Preliminary report [Ｊ]. Dis Colon Rectum, 1986; 29(7): 446-450.
7.	Maldjian C, Smith R, Kilger A, et al. Endorectal surface coil MR imaging as a staging technique for rectal carcinoma: a comparison study to rectal endosonography[Ｊ]. Abdom Imaging, 2000; 25(1): 75-80.
8.	Beets-Tan RG, Beets GL. Rectal cancer: review with emphasis on MR imaging [Ｊ]. Radiology, 2004; 232(2): 335-346.
9.	Halefoglu AM, Yildirim S, Avlanmis O, et al. Endorectal ultrasonography versus phased-array magnetic resonance imaging for preoperative staging of rectal cancer [Ｊ]. World J Gastroenterol, 2008; 14(22): 3504-3510.
10.	Wiggers T, van de Velde CJ. The circumferential margin in rectal cancer. Recommendations based on the Dutch Total Mesorectal Excision Study[Ｊ]. Eur J Cancer, 2002; 38(7): 973-976.
11.	Mnig SP, Baldus SE, Zirbes TK, et al. Lymph node size and metastatic infiltration in colon cancer [Ｊ]. Ann Surg Oncol, 1999; 6(6): 579-581.
12.	Kwok H, Bissett IP, Hill GL. Preoperative staging of rectal cancer [Ｊ]. Int J Colorectal Dis, 2000; 15(1): 9-20.
13.	Lahaye MJ, Engelen SM, Kessels AG, et al. USPIO-enha-nced MR imaging for nodal staging in patients with primary rectal cancer: predictive criteria [Ｊ]. Radiology, 2008; 246(3): 804-811.
14.	Wolberink SV, Beets-Tan RG, Nagtegaal ID, et al. Preoperative assessment of the circumferential margin in rectal cancer is more informative in treatment planning than the T stage [Ｊ]. Tech Coloproctol, 2006; 10(3): 171-176.
15.	Wieder HA, Rosenberg R, Lordick F, et al. Rectal cancer: MR imaging before neoadjuvant chemotherapy and radiation therapy for prediction of tumor-free circumferential resection margins and long-term survival [Ｊ]. Radiology, 2007; 243(3): 744-751.
16.	Brown G, Daniels IR. Preoperative staging of rectal cancer: the MERCURY research project [Ｊ]. Recent Results Cancer Res, 2005; 165: 58-74.
17.	Hildebrandt U, Feifel G. Preoperative staging of rectal cancer by intrarectal ultrasound [Ｊ]. Dis Colon Rectum, 1985; 28(1): 42-46.
18.	Badea R, Badea G, Philippi W, et al. The value and limits of endorectal sonography in the preoperative stage classification of rectal cancer [Ｊ]. Ultraschall Med, 1988; 9(6): 265-269.
19.	Siddiqui AA, Fayiga Y, Huerta S. The role of endoscopic ultrasound in the evaluation of rectal cancer [Ｊ]. Int Semin Surg Oncol, 2006; 3: 36.
20.	Kim JC, Kim HC, Yu CS, et al. Efficacy of 3-dimensional endorectal ultrasonography compared with conventional ultrasonography and computed tomography in preoperative rectal cancer staging [Ｊ]. Am J Surg, 2006; 192(1): 89-97.
21.	Wiersema MJ, Harewood GC. Endoscopic ultrasound for rectal cancer [Ｊ]. Gastroenterol Clin North Am, 2002; 31(4): 1093-1105.
22.	Faneyte IF, Dresen RC, Edelbroek MA, et al. Pre-operative staging with positron emission tomography in patients with pelvic recurrence of rectal cancer [Ｊ]. Dig Surg, 2008; 25(3): 202-207.
23.	汪曉東, 呂東昊, 崔貝貝, 等. 術前經直腸超聲評估直腸癌手術方案的隨機對照試驗 [Ｊ]. 中國循證醫學雜志, 2008; 8(12): 1043-1046.
24.	吳俊華, 汪曉東, 高強, 等. 64排多層螺旋CT和血清淀粉樣蛋白A聯合評估下段直腸癌對手術方案選擇的影響 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(2): 156-161.
25.	汪曉東, 尹源, 陸玫竹, 等. 經直腸超聲聯合血清淀粉樣蛋白A術前評估中低位直腸癌與手術決策的隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(5): 407-412.
26.	汪曉東, 張瓊文, 呂東昊, 等. 64排多層螺旋CT和血清淀粉樣蛋白A聯合評估結腸癌對手術方案選擇的影響 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(3): 232-237.
27.	汪曉東, 呂東昊, 宋歡, 等. 多模式術前評估系統對中低位直腸癌手術方案選擇的價值：一項隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(6): 487-492.
28.	汪曉東, 鄧磊, 呂東昊, 等. 結直腸癌患者術前SAA、CRP、CEA和CA19-9水平的臨床診斷價值 [Ｊ]. 四川醫學, 2009; 30(3): 340-342.
29.	d’Eril GM, Anesi A, Maggiore M, et al. Biological variation of serum amyloid A in healthy subjects [Ｊ]. Clin Chem, 2001; 47(8): 1498-1499.
30.	汪曉東, 宋歡, 呂東昊, 等. 術前聯合評估直腸上段癌與手術方案選擇的隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(4): 322-326.

1. 汪曉東, 宋歡, 盧聰, 等. 骨盆測量在直腸癌手術中的應用進展 [Ｊ]. 醫學與哲學, 2009; 30(4): 45-46.
2. Thoeni RF. Colorectal cancer: cross-sectional imaging for staging of primary tumor and detection of local recurrence [Ｊ]. AJR Am J Roentgenol, 1991; 156(5): 909-915.
3. Rotte KH, Klühs L, Kleinau H, et al. Computed tomography and endosonography in the preoperative staging of rectal carcinoma [Ｊ]. Eur J Radiol, 1989; 9(3): 187-190.
4. Kim NK, Kim MJ, Yun SH, et al. Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer [Ｊ]. Dis Colon Rectum, 1999; 42(6): 770-775.
5. Gollub MJ, Schwartz LH, Akhurst T. Update on colorectal cancer imaging [Ｊ]. Radiol Clin North Am, 2007; 45(1): 85-118.
6. Hodgman CG, MacCarty RL, Wolff BG, et al. Preoperative staging of rectal carcinoma by computed tomography and 0.15 T magnetic resonance imaging. Preliminary report [Ｊ]. Dis Colon Rectum, 1986; 29(7): 446-450.
7. Maldjian C, Smith R, Kilger A, et al. Endorectal surface coil MR imaging as a staging technique for rectal carcinoma: a comparison study to rectal endosonography[Ｊ]. Abdom Imaging, 2000; 25(1): 75-80.
8. Beets-Tan RG, Beets GL. Rectal cancer: review with emphasis on MR imaging [Ｊ]. Radiology, 2004; 232(2): 335-346.
9. Halefoglu AM, Yildirim S, Avlanmis O, et al. Endorectal ultrasonography versus phased-array magnetic resonance imaging for preoperative staging of rectal cancer [Ｊ]. World J Gastroenterol, 2008; 14(22): 3504-3510.
10. Wiggers T, van de Velde CJ. The circumferential margin in rectal cancer. Recommendations based on the Dutch Total Mesorectal Excision Study[Ｊ]. Eur J Cancer, 2002; 38(7): 973-976.
11. Mnig SP, Baldus SE, Zirbes TK, et al. Lymph node size and metastatic infiltration in colon cancer [Ｊ]. Ann Surg Oncol, 1999; 6(6): 579-581.
12. Kwok H, Bissett IP, Hill GL. Preoperative staging of rectal cancer [Ｊ]. Int J Colorectal Dis, 2000; 15(1): 9-20.
13. Lahaye MJ, Engelen SM, Kessels AG, et al. USPIO-enha-nced MR imaging for nodal staging in patients with primary rectal cancer: predictive criteria [Ｊ]. Radiology, 2008; 246(3): 804-811.
14. Wolberink SV, Beets-Tan RG, Nagtegaal ID, et al. Preoperative assessment of the circumferential margin in rectal cancer is more informative in treatment planning than the T stage [Ｊ]. Tech Coloproctol, 2006; 10(3): 171-176.
15. Wieder HA, Rosenberg R, Lordick F, et al. Rectal cancer: MR imaging before neoadjuvant chemotherapy and radiation therapy for prediction of tumor-free circumferential resection margins and long-term survival [Ｊ]. Radiology, 2007; 243(3): 744-751.
16. Brown G, Daniels IR. Preoperative staging of rectal cancer: the MERCURY research project [Ｊ]. Recent Results Cancer Res, 2005; 165: 58-74.
17. Hildebrandt U, Feifel G. Preoperative staging of rectal cancer by intrarectal ultrasound [Ｊ]. Dis Colon Rectum, 1985; 28(1): 42-46.
18. Badea R, Badea G, Philippi W, et al. The value and limits of endorectal sonography in the preoperative stage classification of rectal cancer [Ｊ]. Ultraschall Med, 1988; 9(6): 265-269.
19. Siddiqui AA, Fayiga Y, Huerta S. The role of endoscopic ultrasound in the evaluation of rectal cancer [Ｊ]. Int Semin Surg Oncol, 2006; 3: 36.
20. Kim JC, Kim HC, Yu CS, et al. Efficacy of 3-dimensional endorectal ultrasonography compared with conventional ultrasonography and computed tomography in preoperative rectal cancer staging [Ｊ]. Am J Surg, 2006; 192(1): 89-97.
21. Wiersema MJ, Harewood GC. Endoscopic ultrasound for rectal cancer [Ｊ]. Gastroenterol Clin North Am, 2002; 31(4): 1093-1105.
22. Faneyte IF, Dresen RC, Edelbroek MA, et al. Pre-operative staging with positron emission tomography in patients with pelvic recurrence of rectal cancer [Ｊ]. Dig Surg, 2008; 25(3): 202-207.
23. 汪曉東, 呂東昊, 崔貝貝, 等. 術前經直腸超聲評估直腸癌手術方案的隨機對照試驗 [Ｊ]. 中國循證醫學雜志, 2008; 8(12): 1043-1046.
24. 吳俊華, 汪曉東, 高強, 等. 64排多層螺旋CT和血清淀粉樣蛋白A聯合評估下段直腸癌對手術方案選擇的影響 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(2): 156-161.
25. 汪曉東, 尹源, 陸玫竹, 等. 經直腸超聲聯合血清淀粉樣蛋白A術前評估中低位直腸癌與手術決策的隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(5): 407-412.
26. 汪曉東, 張瓊文, 呂東昊, 等. 64排多層螺旋CT和血清淀粉樣蛋白A聯合評估結腸癌對手術方案選擇的影響 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(3): 232-237.
27. 汪曉東, 呂東昊, 宋歡, 等. 多模式術前評估系統對中低位直腸癌手術方案選擇的價值：一項隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(6): 487-492.
28. 汪曉東, 鄧磊, 呂東昊, 等. 結直腸癌患者術前SAA、CRP、CEA和CA19-9水平的臨床診斷價值 [Ｊ]. 四川醫學, 2009; 30(3): 340-342.
29. d’Eril GM, Anesi A, Maggiore M, et al. Biological variation of serum amyloid A in healthy subjects [Ｊ]. Clin Chem, 2001; 47(8): 1498-1499.
30. 汪曉東, 宋歡, 呂東昊, 等. 術前聯合評估直腸上段癌與手術方案選擇的隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(4): 322-326.

《中國普外基礎與臨床雜志》

直腸癌術前分期策略

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《中國普外基礎與臨床雜志》

直腸癌術前分期策略

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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