Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Pulmonary Metastasis from Rectal Cancer on Chest CT Is Correlated with 3T MRI Primary Tumor Location

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

  • Han, Na-Yeon (Department of Radiology, Anam Hospital, Korea University College of Medicine) ;
  • Kim, Min-Ju (Department of Radiology, Anam Hospital, Korea University College of Medicine) ;
  • Park, Beon-Jin (Department of Radiology, Anam Hospital, Korea University College of Medicine) ;
  • Sung, Deuk-Jae (Department of Radiology, Anam Hospital, Korea University College of Medicine) ;
  • Chung, Kyoo-Byung (Department of Radiology, Anam Hospital, Korea University College of Medicine) ;
  • Oh, Yu-Whan (Department of Radiology, Anam Hospital, Korea University College of Medicine)
  • 한나연 (고려대학교 의과대학 안암병원 영상의학과학교실) ;
  • 김민주 (고려대학교 의과대학 안암병원 영상의학과학교실) ;
  • 박범진 (고려대학교 의과대학 안암병원 영상의학과학교실) ;
  • 성득제 (고려대학교 의과대학 안암병원 영상의학과학교실) ;
  • 정규병 (고려대학교 의과대학 안암병원 영상의학과학교실) ;
  • 오유환 (고려대학교 의과대학 안암병원 영상의학과학교실)
  • Published : 2011.08.01
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Abstract

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.

목적: 흉부단층촬영에서의 폐 전이 빈도와 3T 직장 자기공명영상에서 직장암의 위치간 상관관계를 연구하고자 하는 것이다. 대상과 방법: 선암으로 진단된 109명의 환자에서 치료시작 전 2주 이내에 3T 직장 자기공명촬영과 흉부단층촬영을 시행하였다. 두 명의 영상의학과 의사가 합의 하에 직장 자기공명촬영에서 종양의 위치를 항문연에서의 거리에 따라 상부(10~15 cm), 중부(5~10 cm), 하부(< 5 cm)의 세 부분으로 나누었다. 폐 전이 평가를 위해 흉부단층촬영을 후향적으로 검토하였다. 피셔의 정확검정을 이용하여 폐 전이의 빈도와 직장암의 위치 사이의 관련성에 대하여 평가하였으며, 맨틀-헨젤 검정을 통해 T-병기의 영향을 배제하였다. 결과: 109명의 환자 중, 15 cm 이상의 위치에 있는 2명의 종양은 S상 결장암으로 생각하여 제외하였고 나머지 107명 중에서 직장 중부의 종양은 직장의 정맥 해부학을 고려하여 볼 때, 정맥 배출이 다양하여 제외하였다. 상부(n = 26)와 하부(n = 34) 직장선암을 가진 60명의 환자를 연구에 포함하였다. 흉부단층촬영에서 9명의 환자(15%)가 폐 전이를 보였으며, 이 중 8명의 환자(24%, 8/24)는 하부 직장암을 가진 환자였다. T-병기의 영향을 배제하였을 때 두 군 간에 폐 전이의 빈도는 통계적으로 유의한 차이를 보였다(p < 0.05). 결론: 직장암에서의 폐 전이는 T-병기의 영향이 제외되었을 때 하부직장암에서 더 높은 빈도를 보였다.

Keywords

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