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頁籤選單縮合
題 名 | Computed Tomography in the Postoperative Surveillance of Stage III Colorectal Cancers Receiving Adjuvant Chemotherapy=電腦斷層用於接受手術與輔助性化療後之第三期大腸癌病人的追蹤 |
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作 者 | 楊濱輔; 陳巧雲; 高理鈞; 馬政仁; 陳芳銘; 陳漢文; 黃哲人; 謝建勳; 王照元; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷 期 | 23:4 2012.12[民101.12] |
頁 次 | 頁144-150 |
分類號 | 416.245 |
關鍵詞 | 電腦斷層; 術後追蹤; 第三期大腸直腸癌; Computed tomography; Postoperative surveillance; Stage III colorectal cancers; |
語 文 | 英文(English) |
中文摘要 | 目的 大腸直腸癌在台灣是最常見的惡性腫瘤。大腸直腸癌的病人即使接受完整的手術治療,還是有30~50%會復發。早期發現腫瘤復發是術後追蹤的首要目標。在第三期大腸直腸癌手術及輔助性治療後追蹤工具以電腦斷層為主。然而電腦斷層攝影在臨床常規檢查的診斷正確性仍然是未明。方法 從2008年1月至2011年二月,我們統計並分析了115個接受過手術併輔助性治療的第三期大腸直腸癌病人,這些病人皆是高醫的病人。就電腦斷層對診斷大腸直腸癌術後局部復發和遠端轉移的敏感性,特異性,陽性預測值,陰性預測值,和正確度進行分析。結果 大腸癌及直腸癌的病人中,在年齡(p=0.798),性別(p=0.242),腫瘤大小(p=0.288),腫瘤侵犯深度(p=0.059),和淋巴結轉移(p=0.557)統計上沒有顯著的差異。在電腦斷層對遠端轉移的敏感性,特異性,陽性預測值,陰性預測值,和正確度方面,大腸癌和直腸癌是相似的。然而,在電腦斷層對診斷局部復發的敏感性,大腸癌(22.2%)相對比直腸癌(50%)較低。大腸癌及直腸癌的病人中,在年齡(p=0.798),性別(p=0.242),腫瘤大小(p=0.288),腫瘤侵犯深度(p=0.059),和淋巴結轉移(p=0.557)統計上沒有顯著的差異。在電腦斷層對遠端轉移的敏感性,特異性,陽性預測值,陰性預測值,和正確度方面,大腸癌和直腸癌是相似的。然而,在電腦斷層對診斷局部復發的敏感性,大腸癌(22.2%)相對比直腸癌(50%)較低。結論 我們的研究指出在大腸癌和直腸癌的病人,電腦斷層在診斷局部復發的敏感性明顯較低於診斷遠端轉移的敏感性。所以,對於接受輔助性治療的大腸直腸癌病人,應該安排更精確的影像工具去改善偵測局部復發的正確度。 |
英文摘要 | Purpose. Colorectal cancer (CRC) is the most common malignancy in Taiwan. Approximately 30-50% of CRC patients receiving radical resection will eventually develop postoperative relapse. Surveillance for early detection of postoperative relapse is the ideal goal, and computed tomography (CT) scan is the crucial tool for such surveillance for stage III CRC patients administrated with adjuvant chemotherapy; however, the routine role of CT scan in the post-chemotherapeutic surveillance in local recurrence or distant metastasis of these patients in the clinical practice remains largely unknown.Methods. From January 2008 to February 2011, a retrospective analysis of 115 stage III CRC patients undergoing primary lesion resection following by adjuvant chemotherapy was investigated. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT scan for the diagnosis of postoperative local recurrence and distant metastasis were analyzed.Results. There were no significant differences between colon and rectal cancer patients in age (p=0.798), gender (p=0.242), tumor size (p=0.288), tumor depth (p=0.059), and lymph node metastasis (p=0.557).The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT scan for colon cancer or rectal cancer patients in the diagnosis of distant metastasis are similar. However, the sensitivity of CT scan in the diagnosis of local recurrence in colon cancer (22.2%) and rectal cancer (50%) was relatively low.Conclusion. Our study showed that the sensitivity for diagnosis of local recurrence in colon and rectal cancer patients is prominently lower than that of distant metastasis by CT scan. Therefore, more precise image studies in the surveillance may be mandatory to improve accurate detection of local recurrence for CRC patients following adjuvant chemotherapy. |
本系統中英文摘要資訊取自各篇刊載內容。