Title Extramural vascular invasion detected by contrast-enhanced multiple-row detectors computed tomography (ceMDCT) as a predictor of synchronous metastases in colon cancer
Authors Yang, Su-Xing
Yao, Xun
Song, Xing-He
Cui, Yan-Cheng
Ye, Ying-Jiang
Wang, Yi
Affiliation Aerosp Ctr Hosp, Dept Radiol, Beijing 100049, Peoples R China.
Peking Univ, Dept Gastrointestinal Surg, Peoples Hosp, Beijing 100044, Peoples R China.
Keywords colon cancer
synchronous metastases
contrast-enhanced computed tomography
extramural vascular invasion
COLORECTAL-CANCER
RECTAL-CANCER
PROGNOSTIC-SIGNIFICANCE
LIVER METASTASES
NODE METASTASIS
MRI
CT
CARCINOMA
METAANALYSIS
SURVIVAL
Issue Date 2017
Publisher ONCOTARGET
Citation ONCOTARGET. 2017, 8(55), 94883-94892.
Abstract Background: Extramural Vascular Invasion (EMVI) is histologically defined as the presence of tumor cells beyond the muscularis propria in vessels resulting in disease metastases. Objective: To determine whether EMVI, detected by contrast-enhanced multiple-row detectors computed tomography (MDCT), has closely association with synchronous metastases in colon cancer. Methods: Patients with pathology proven colon cancer were included in this retrospective study. Preoperative imaging status, including Extramural tumor depth, Lymph nodes, tumor location, and ctEMVI status, were defined on MDCT. Postoperative pathological tumor stage, lymph node stage, and tumor differentiation, were defined in accordance with the American Joint Committee on Cancer (AJCC) 7th Edition. Synchronous metastases were detected on follow-up MDCT 3 months after initial diagnosis or by surgery, if available. Associations between ctEMVI and other preoperative and postoperative factors were analyzed using Chi-squared tests. Logistic regression analyses were performed to analyze the preoperative and postoperative factors of synchronous metastases in colon cancer. Results: ctEMVI was observed in 96 patients (96/241, 39.8%). The presence of ctEMVI varied significantly depending on ctEMD (X-2 = 66.557, P < 0.001), lymph nodes status on MDCT (X-2 = 24.533, P = 0.001), pathological tumor status (X-2 = 36.267, P < 0.001) and pathological lymph nodes status analyses (X-2 = 32.103, P < 0.001). Synchronous metastases were seen in 36 patients (36/96, 37.5%) with ctEMVI and 11 (11/145, 7.6%) patients without ctEMVI. The incidence of synchronous metastases was significantly higher in the cohort of positive ctEMVI with odds ratio (OR) of 7.309 (95% CI 3.485 similar to 15.330, P<0.001). Positive ctEMVI (Odds ratio 4.654, 95% CI: 1.987 similar to 0.898, P < 0.001) and ctEMD larger than 5 mm (Odds ratio 2.654, 95% CI: 1.116 similar to 6.309, P = 0.027) were demonstrated to be significant preoperative factors in predicting synchronous metastases. Conclusion: MDCT-detected EMVI could be used as a preoperative factor to predict synchronous metastases in colon cancer.
URI http://hdl.handle.net/20.500.11897/497631
ISSN 1949-2553
DOI 10.18632/oncotarget.22034
Indexed SCI(E)
PubMed
Appears in Collections: 人民医院

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