Outcome Evaluation of 3.0T MRI Multimodal Technique Combined with Serum ERCC1 in Neoadjuvant Therapy for Locally Advanced Rectal Cancer
Objective To explore the clinical value of 3.0T MRI multimodal technique combined with serectomy repair Cross complementary gene 1(ERCC1)in evaluating the outcome of neoadjuvant therapy for locally advanced rectal cancer(LARC).Methods 170 LARC patients in our hospital from January 2020 to October 2022 were selected and randomly divided into modeling population(119 cases)and verification population(51 cases)according to a ratio of 7∶3.All patients received neoadjuvant therapy,3.0T MRI multimodal technology scanning and serum ERCC1 mRNA detection before treatment.After 8 weeks of neoadjuvant therapy,surgical treatment was performed,and intraoperative lesion tissue was taken to evaluate tumor regression grade.The quantitative parameters of multi-modal MRI,such as volume transfer constant(Ktrans),interstitial plasma rate constant(Kep),extravascular extracellular space volume fraction(Ve),apparent diffusion coefficient(ADC),and serum ERCC1 mRNA expression level were compared before treatment in patients with different tumor regression grade.The quantitative MRI parameters and serum ERCC1 mRNA expression levels of patients with different clinical stages before treatment were compared,and the correlation between each indicator and the clinical stage before treatment and the tumor regression grade after treatment was analyzed.The value of each indicator in predicting tumor regression grade was evaluated by receiver operating characteristic curve(ROC)and clinical decision curve(DCA).Results The mRNA expression levels of Ktrans,Ve,Kep and ERCC1 in patients with non-pathological complete response(pCR)before treatment were higher than those in pCR patients,and ADC was lower than those in pCR patients(P＜0.05).The mRNA expression levels of Ktrans,Ve,Kep and ERCC1 in stage Ⅱpatients were lower than those in stage Ⅲ patients,and ADC was higher than those in stage Ⅲ patients(P＜0.05).The mRNA expression levels of Ktrans,Ve,Kep and serum ERCC1 were positively correlated with clinical stage and negatively correlated with tumor regression grade,while ADC was negatively correlated with clinical stage and positively correlated with tumor regression grade(P＜0.05).In the modeling population,the combination of MRI quantitative parameters and serum ERCC1 mRNA before treatment had the largest AUC in predicting the tumor regression grade to pCR.The combined prediction of MRI quantitative parameters and serum ERCC1 mRNA showed a significant positive net benefit in the population.Conclusion Quantitative MRI parameters and serum ERCC1 are related to clinical stage and tumor regression grade of patients,and the combination of these indicators has good predictive value and clinical applicability in predicting tumor regression grade to pCR.
万方数据
维普
