LV Donghao 1 , GAO Qiang 1 , WANG Xiaodong 2 , DENG Lei 1 , OUYANG Shurui 1 , FANG Chao 1 , LI Zhengyan 3 , LI Li 2
  • 1.West China School of Medicine/West China Hospital, Sichuan University, Chengdu 610041, China;;
  • 2.Department of Anal-Colorectal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;;
  • 3.Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, ChinaCorresponding Author: LI Li, E-mail: drlili116@126.com;
Rectal neoplasm; Operation; Multi-slice spiral computed tomography; Serum amyloid A protein; C-reactive protein; Preoperative evaluation; Multi-disciplinary team
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Objective 　To determine the influence and significance of combinative assessment of 64 multi-slice spiral computed tomography (MSCT) with serum amyloid A protein (SAA) or C-reactive protein (CRP) on the selection of operative procedures of rectal cancer under the multi-disciplinary team.
Methods 　Prospectively enrolled patients diagnosed definitely as rectal cancer at West China Hospital of Sichuan University from February to August 2009 were randomly assigned into two groups. In one group named MSCT+SAA group, both 64 MSCT and SAA combinative assessment were made for the preoperative evaluation. In another group named MSCT+CRP group, both MSCT and CRP combinative assessment were made for preoperative evaluation. Furthermore, the preoperative staging and predicted operation procedures were compared with postoperative pathologic staging and practical operation procedures, respectively, and the relationship between the choice of operation procedures and clinicopathologic factors was analyzed.
Results 　All 165 patients were randomly assigned into MSCT+SAA group (n=83) and MSCT+CRP group (n=82). The baseline characteristics of two groups were statistically similar (P gt;0.05). For MSCT+SAA group, the accuracies of preoperative staging T, N, M and TNM were 74.7%， 68.7%, 100% and 66.3%, respectively. For MSCT+CRP group, the accuracies of preoperative staging T, N, M and TNM were 72.0%, 86.6%, 100% and 81.7%, respectively. There were statistically significant differences in the accuracies of N staging and TNM staging between two groups (P＜0.05). However, there was no statistically significant difference of the accuracy of prediction to operative procedures between two groups (90.4% vs. 95.1%, P gt;0.05). The pathological T staging (P＜0.001), N staging (P＜0.001), TNM staging (P＜0.001), preoperative serum level of SAA (P=0.010), serum level of CRP (P=0.042), and distance of tumor to the dentate line (P=0.011) were associated with the operative procedures.
Conclusion 　Combinative assessment of MSCT+CRP could improve the accuracy of preoperative staging and operative procedures prediction, which may be superior to MSCT+SAA.

Citation： LV Donghao,GAO Qiang,WANG Xiaodong,DENG Lei,OUYANG Shurui,FANG Chao,LI Zhengyan,LI Li. Randomized Controlled Trial of Combining Multi-Slice Spiral Computed Tomography with Inflammatory Biomarkers on Rectal Cancer Surgical Decision Making. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(10): 851-855. doi: Copy