Evaluation of transrectal ultrasound-guided tru-cut biopsy as a complementary method for predicting pathological complete response in rectal cancer after neoadjuvant treatment: a phase II prospective and diagnostic trial

作者：Yaoyi Huang, Yumo Xie, Puning Wang, Yao Chen, Si Qin, Fangqian Li, Yuanhui Wu, Mingzhe Huang, Zehui Hou, Yonghua Cai, Xiaosheng He, Hongcheng Lin, Bang Hu, Qiyuan Qin, Tenghui Ma, Shuyun Tan, Yi Liao, Jia Ke, Di Zhang, Sicong Lai, ZhiPeng Jiang, Huaiming Wang, Jun Xiang, Zerong Cai, Hui Wang, Xiaowen He, Zuli Yang, Donglin Ren, Xiaojian Wu, Yisong Hong, Meijin Huang, Yanxin Luo, Guangjian Liu, Jinxin Lin · 发表于：International Journal of Surgery · 年份：2024 · DOI：10.1097/js9.0000000000001152 · 被引用次数：7 · 研究领域：Colorectal Cancer Surgical Treatments、Colorectal and Anal Carcinomas、Esophageal Cancer Research and Treatment

IMPORTANCE: Patients with pathological complete response (pCR) of rectal cancer following neoadjuvant treatment had better oncological outcomes. However, reliable methods for accurately predicting pCR remain limited. OBJECTIVE: To evaluate whether transrectal ultrasound-guided tru-cut biopsy (TRUS-TCB) adds diagnostic value to conventional modalities for predicting pathological complete response in patients with rectal cancer after neoadjuvant treatment. DESIGN, SETTING, AND PARTICIPANTS: This study evaluated data of patients with rectal cancer who were treated with neoadjuvant treatment and reassessed using TRUS-TCB and conventional modalities before surgery. This study is registered with ClinicalTrials.gov. MAIN OUTCOMES AND MEASURES: The primary outcome was accuracy, along with secondary outcomes including sensitivity, specificity, negative predictive value, and positive predictive value in predicting tumour residues. Final surgical pathology was used as reference standard. RESULTS: Between June 2021 and June 2022, a total of 74 patients were enroled, with 63 patients ultimately evaluated. Among them, 17 patients (28%) exhibited a complete pathological response. TRUS-TCB demonstrated an accuracy of 0.71 (95% CI, 0.58-0.82) in predicting tumour residues. The combined use of TRUS-TCB and conventional modalities significantly improved diagnostic accuracy compared to conventional modalities alone (0.75 vs. 0.59, P =0.02). Furthermore, TRUS-TCB correctly reclassified 52% of pat...