Influence of Combinative Assessment of 64 Multi-Slice Spiral ＣＴ and Serum Amyloid A Protein onOperative Procedures’ Prediction of Lower Rectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Junhua ¹ , WANG Xiaodong ² , GAO Qiang ³ , L Donghao ³ , ZENG Rong ⁴ , LI Li. ²

1.Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China;;
2.Department of Anal-Colorectal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;;
3.West China Medical School, Sichuan University, Chengdu 610041, China;;
4.Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, ChinaCorresponding Author: LI Li, E-mail: drlili116@126.com;

Corresponding author：

Keywords：

Rectal neoplasm; Surgical operation; Multi-slice spiral computer tomography; Preoperative assessment; Serum amyloid protein A

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Objective To determine the influence of combinative assessment of 64 multi-slice spiral computer tomography (MSCT) and serum amyloid A protein (SAA ) on the selection of operative procedures in lower rectal cancer.
MethodsProspectively enrolled 130 patients diagnosed definitely as lower rectal cancer (distance of tumor to the dentate line ≤7 cm) at West China Hospital of Sichuan University from July 2007 to September 2008 were randomly assigned into two groups with 65 participants, respectively. In one group named MSCT+SAAgroup, both 64 MSCT and SAA combinative assessment were made for the preoperative evaluation. In another group named MSCT group, only the preoperative MSCT was made. Furthermore, the preoperative staging and predicted operation procedures were compared with postoperative pathologic staging and practical operation program, respectively.
ResultsAccording to the criteria, 119 patients with colorectal cancer were actually included into MSCT+SAA group (n=58) and MSCT group (n=61). The baselines characteristics of two groups were basically identical. For MSCT+SAAgroup, the accuracies of preoperative staging T, N, M and TNM were 89.66%, 79.31%, 100% and 77.59%, respectively; For MSCT group, the corresponding rates were 86.89%, 70.49%, 100% and 65.57%, respectively. There was a statistically significant difference of the accuracy of prediction to operative procedures in two groups (93.10% vs. 80.33%, P=0.041). The clinical staging　(P=0.001), preoperative T staging (P=0.000), M staging
(P=0.016), TNM staging (P=0.013) and serum level of SAA (P=0.029) were related to the selection of operative procedures when analyzing the relationship between the operative procedures and multiple clinicopathologic factors in lower rectal cancer. ConclusionCombinative assessment of 64 MSCT and SAA could improve the accuracy of preoperative staging, thus provide higher predictive coincidence rate to operative procedures for surgeon.

Citation： WU Junhua,WANG Xiaodong,GAO Qiang,L Donghao,ZENG Rong,LI Li.. Influence of Combinative Assessment of 64 Multi-Slice Spiral ＣＴ and Serum Amyloid A Protein onOperative Procedures’ Prediction of Lower Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(2): 156-161. doi: Copy

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1. Moss AA, Thoeni RF, Schnyder P, et al. Value of computed tomography in the detection and staging of recurrent rectal carcinomas [Ｊ]. J Comput Assist Tomogr, 1981; 5(6)： 870.
2. Glojnari＇c I, Casl MT, Simi＇c D, et al. Serum amyloid A protein (SAA) in colorectal carcinoma [Ｊ]. Clin Chem Lab Med, 2001; 39(2)： 129.
3. Huh JW, Park YA, Jung EJ, et al. Accuracy of endorectal ultrasonography and computed tomography for restaging rectal cancer after preoperative chemoradiation [Ｊ]. J Am Coll Surg, 2008; 207(1)： 7.
4. Bipat S, Glas AS, Slors FJ, et al. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT and MR imaging: a meta-analysis [Ｊ]. Radiology, 2004; 232(3)： 773.
5. Biran H, Friedman N, Neumann L, et al. Serum amyloid A (SAA) variations in patients with cancer: correlation with disease activity, stage, primary site, and prognosis [Ｊ]. J Clin Pathol, 1986; 39(7)： 794.
6. Coussens LM, Werb Z. Inflammation and cancer [Ｊ]. Nature, 2002; 420(6917)： 860.
7. Michaeli A, Finci-Yeheskel Z, Dishon S, et al. Serum amyloid A enhances plasminogen activation: implication for a role in colon cancer[Ｊ]. Biochem Biophys Res Commun, 2008; 368(2)： 368.
8. 李立. 结直肠癌外科应用技术的规范与创新（一）[Ｊ]. 中国普外基础与临床杂志, 2006; 13(1)： 106.
9. 蔡三军. 直肠癌的外科治疗进展[Ｊ]. 中国癌症杂志, 2004; 14(5)： 410.
10. Miwata H, Yamada T, Okada M, et al. Serum amyloid A protein in acute viral infections[Ｊ]. Arch Dis Child, 1993; 68(2)： 210.
11. 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.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Influence of Combinative Assessment of 64 Multi-Slice Spiral ＣＴ and Serum Amyloid A Protein onOperative Procedures’ Prediction of Lower Rectal Cancer

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