흉부단층촬영에서 발견되는 폐 전이의 빈도와 3T 직장자기공명영상에서의 종양의 위치 사이의 관련성

초록

Purpose: To evaluate the association between the incidence of pulmonary metastasis on chest CT and the location of the primary tumor on rectal MRI. Materials and Methods: One hundred and nine consecutive patients with rectal adenocarcinoma underwent chest CT and 3T rectal MRI. Two radiologists classified the tumor on MRI as an upper (> 10 cm from the anal verge), mid (5-10 cm), or lower rectal tumor (< 5 cm) by consensus. All chest CT scans were retrospectively reviewed for the presence of metastasis. We used Fisher’s exact test to evaluate the correlation between the incidence of pulmonary metastasis with the location of the rectal cancer and the Mantel-Haenszel test to control for local tumor stage. Results: We only included the 60 patients with upper (n = 26) or lower (n = 34) rectal cancer, because of the complicated venous drainage system of the mid rectum. Among these, 9 (15%) showed evidence of pulmonary metastasis on chest CT and almost all (89%, 8/9) patients had lower rectal cancer. The incidence of pulmonary metastasis between the two groups was statistically different (p < 0.05) when local tumor stage was controlled. Conclusion: The incidence of pulmonary metastasis was significantly higher for lower than upper rectal cancers when the T-stage of the tumor was accounted for.

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