Correlative Investigation Of MRI Findings And Clinicopathological Factors With Lymph Node Metastasis In Stage T3 Rectal Adenocarcinoma

ObjectiveBy studying the correlation between MRI imaging signs and clinicopathological factors of primary tumors of T3 colorectal adenocarcinoma and lymph node metastasis,the accuracy of the diagnosis of lymph node metastasis can be improved to guide the clinical selection of the best treatment scheme.MethodsFrom May 2017 to December 2019,62 patients with stage T3 rectal adenocarcinoma confirmed by pathology at the First Affiliated Hospital of Jinzhou Medical University were collected.The features were analyzed as follows: age,sex,the location of the tumor,lesion length and thickness,the relationship between the center of the lesion and peritoneal reflection(hereinafter referred to as relationship with peritoneal reflection),the circumference of the lesion around the intestine,Apparent diffusion coefficient(ADC)value,sub-classification of T3 rectal cancer,gross type,degree of differentiation,vascular invasion,perineural invasion and lymph node metastasis.The consistency of data measurement between 2 observers with interclass correlation coefficient(ICC)and Kappa-test were checked.The differences of imaging findings and clinicopathological factors between the positive group and the negative group with lymph node metastasis were compared.The related factors with statistical significance were included in theanalysis of Logistic regression equation.The receiver operating characteristic curve(ROC)was used to obtain the critical value for predicting lymph node metastasis in stage T3 rectal adenocarcinoma.ResultsThere were a total of 62 patients with T3 stage rectal adenocarcinoma,including 26 in the positive group and 36 in the negative group with lymph node metastasis,with a lymph node metastasis rate of 41.9%.Univariate analysis showed that the relationship between lesion thickness,the relationship between the center of the lesion and peritoneal reflection,the degree of differentiation,perineural invasion and vascular invasion were correlated with lymph node metastasis,with statistical significance(P=0.000,0.025,0.041,0.001,0.000,respectively).Multivariate Logistic regression analysis showed that tumor thickness and vascular invasion were independent predictor for lymph node metastasis.The ROC curve showed that the critical value,sensitivity and specificity of lesion thickness for predicting lymph node metastasis in stage T3 rectal adenocarcinoma were 1.56 cm,76.9% and 83.3%,respectively.Conclusions1.The lesion thickness in MRI image sign can be used as an index to judge the lymph node metastasis of stage T3 rectal carcinoma.It can i mprove the accuracy of diagnosis of lymph node metastasis and guide th e clinic to determine the best treatment before operation.2.Vascular invasion is an independent predictor of lymph node metastasis among clinicopathological factors.