- 作者：Matthew H. Lee ; MD ; mlee2@uwhealth.org" class="auth_mail" title="E-mail the corresponding author ; J. Louis Hinshaw ; MD ; David H. Kim ; MD ; Perry J. Pickhardt ; MD
- 关键词：CT colonography ; colorectal cancer ; tumor-related symptoms ; tumor characteristics
- 刊名：Academic Radiology
- 出版年：2016
- 出版时间：June 2016
- 年：2016
- 卷：23
- 期：6
- 页码：712-717
- 全文大小：706 K
Materials and Methods
This is a retrospective analysis of all pathology-confirmed cases of CRC evaluated with CTC at our institution from October 2004 to October 2012. Cases were reviewed to determine tumor size, morphology, and degree of luminal narrowing. An electronic medical record review was performed to delineate specific patient symptomatology and determine depth of invasion.
Results
A total of 55 patients (36 symptomatic and 19 asymptomatic) with a total of 63 CRCs were evaluated by CTC during the study time period. The most common symptoms were gastrointestinal (GI) bleeding/anemia (n = 26), followed by obstructive symptoms (n = 23), and constitutional symptoms (n = 5). Symptomatic cancers were more likely to have annular morphology (n = 30/43, 70% vs. n = 3/20, 15%; odds ratio [OR] = 13.1, P = 0.0003), whereas asymptomatic cancers were more likely to be polypoid (n = 11/20, 55% vs. n = 6/43, 14%, OR = 7.5, P = 0.001). Symptomatic cancers were also larger (46.1 ± 22.4 vs. 38.8 ± 18.4 mm, P = 0.005) and resulted in greater luminal narrowing (8.7 ± 8.5 mm vs. 35.8 ± 18.8 mm, P < 0.0001) with deeper invasion (n = 29/35 [invasion unknown for 8 cases], 83% vs. n = 6/20, 30%, OR = 11.3, P = 0.0003). Invasive cancers were more likely to have annular morphology (66%, 23/25, P = 0.002).
Conclusions
There is an intuitive and predictable relationship between tumor characteristics on CTC and patient symptoms. Annular morphology, tumor size, degree of luminal narrowing, and invasive disease all correlate with the presence of symptoms.