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Nomogram for prediction of pathologic complete remission using biomarker expression and endoscopic finding after preoperative chemoradiotherapy in rectal cancer

查看全文 作　　者：Hyuk [1]Hur;Min Soo [1]Cho;Woong Sub [2]Koom;Joon Seok [3]Lim;Tae Il [4]Kim;Joong Bae [5]Ahn;Hoguen [6]Kim;Nam Kyu [1]Kim 高影响力作者 机构地区：[1]Division of Colon and Rectal Surgery,Department of Surgery,Severance Hospital,Yonsei University College of Medicine,Seoul 03722,Korea;[2]Department of Radiation Oncology,Severance Hospital,Yonsei University College of Medicine,Seoul 03722,Korea;[3]Departm ent of Radiology,Research Institute of Radiological Science,Severance Hospital,Yonsei University College of Medicine,Seoul 03722,Korea;[4]Department of Internal Medicine,Institute of Gastroenterology;[5]Department of Medical Oncology,Severance Hospital,Yonsei University College of Medicine,Seoul 03722,Korea;[6]Department of Pathology,Severance Hospital,Yonsei University College of Medicine,Seoul 03722,Korea高影响力机构 出　　处：《Chinese Journal of Cancer Research》索引2020年第32卷第2期,共14页高影响力期刊 基　　金：supported by faculty research grant(No.62016-0060)from Yonsei University College of Medicine。 摘　　要：Objective:The aim of this study is to develop a nomogram for prediction of pathologic complete remission(p CR)after preoperative chemoradiotherapy(CRT)for rectal cancer.Methods:m RNA expression levels of seven molecular markers[p53,p21,Ki-67,vascular endothelial growth factor(VEGF),CD133,CD24,CD44]were measured by reverse transcriptase polymerase chain reaction(RTPCR)in 120 rectal cancers.Endoscopic findings of clinical complete remission(c CR)and biologic variables were used to construct nomogram in the training group(n=80),which was validated in the validation group(n=40).Results:m RNA expression levels of four markers(p53,p21,Ki67,CD133)correlated with p CR(24/80,30.0%)in the training group.Low expression of p53 and/or high expression of p21,Ki67 and CD133 showed greater p CR rate.p CR was shown in 18(69.2%)of 26 cases showing endoscopic c CR in the training group.Higher p CR rate was demonstrated in lower tumor location than middle tumor(19/49,38.8%vs.5/31,16.1%).A nomogram for prediction of p CR was developed from the multivariate prediction model using these six variables,which showed good discrimination ability in the training group[area under the curve(AUC)=0.945]and validation group(AUC=0.922).The calibration plot showed good agreement between actual and predicted p CR in both patient groups.Conclusions:Nomogram for assessment of p CR can be useful for making treatment decisions after CRT according to predicted responses. 关 键 词：Rectal cancer CHEMORADIOTHERAPY treatment response molecular marker ENDOSCOPY NOMOGRAM
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