直肠癌术语：RSR、AOR和RATRO专家工作组达成的一致意见

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统一术语是肿瘤学跨学科交流取得成功的必要条件。直肠癌的解剖学、病理形态学和临床术语多种多样，国内外科学文献对这些术语的解释往往模棱两可。这不仅使专科医生之间的交流变得复杂，而且难以比较不同医疗机构的直肠癌治疗效果。

根据对国内外关于直肠癌的现代科学和方法学文献的分析，选出了恶性肿瘤诊断和治疗计划中使用的关键术语，然后由俄罗斯放射科医师协会（Russian Society of Radiology，RSR）、 俄罗斯肿瘤科医生协会（Associations of Oncologists of Russia，AOR）和俄罗斯医疗放射肿瘤科医生协会（Russian Association of Therapeutic Radiation Oncologists，RATRO）的专家对这些术语的解释进行了两次在线讨论，直到专家们就所有项目达成共识（≥80%）。 未达成共识的术语没有被纳入最终清单。

这项研究产生了一份用于直肠癌诊断、分期和治疗计划的解剖学、病理形态学和临床术语清单，并通过专家共识确定了这些术语的释义。

建议一份术语表，用于描述和制定直肠癌患者诊断检查的结论。

作者简介

Tatiana P. Berezovskaya

A.F. Tsyba Medical Radiological Research Center ― branch National Medical Research Radiological Center

Email: tberezovska@yahoo.com
ORCID iD: 0000-0002-3549-4499
SPIN 代码: 5837-3465

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Obninsk

Natalia A. Rubtsova

P.A. Herzen Moscow Research Oncological Institute ― branch National Medical Research Radiological Center

Email: rna17@ya.ru
ORCID iD: 0000-0001-8378-4338
SPIN 代码: 9712-9091

MD, Dr. Sci. (Med.)

俄罗斯联邦, Moscow

Valentin E. Sinitsyn

Lomonosov Moscow State University

Email: vsin@mail.ru
ORCID iD: 0000-0002-5649-2193
SPIN 代码: 8449-6590

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow

Irina V. Zarodnyuk

State Scientific Centre of Coloproctology

Email: zarodnyuk_iv@gnck.ru
ORCID iD: 0000-0002-9442-7480
SPIN 代码: 8310-8989

MD, Dr. Sci. (Med.)

俄罗斯联邦, Moscow

Nicolai V. Nudnov

Russian Scientific Center of Roentgenoradiology

Email: nudnov@mrrc.ru
ORCID iD: 0000-0001-5994-0468
SPIN 代码: 3018-2527

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow

Andrei V. Mishchenko

N.N. Petrov National Medical Research Centre of Oncology

Email: dr.mishchenko@mail.ru
ORCID iD: 0000-0001-7921-3487
SPIN 代码: 8825-4704

MD, Dr. Sci. (Med.)

俄罗斯联邦, Moscow

Yuliya L. Trubacheva

State Scientific Centre of Coloproctology

Email: trubacheva_ul@gnck.ru
ORCID iD: 0000-0002-8403-195X
SPIN 代码: 3427-9074

MD, Dr. Sci. (Med.)

俄罗斯联邦, Moscow

Tatiana A. Bergen

E. Meshalkin National Medical Research Center

Email: tbergen@yandex.ru
ORCID iD: 0000-0003-1530-1327
SPIN 代码: 5467-7347

MD, Dr. Sci. (Med.)

俄罗斯联邦, Moscow

Pavel Yu. Grishko

N.N. Petrov National Medical Research Centre of Oncology

Email: dr.grishko@mail.ru
ORCID iD: 0000-0003-4665-6999
SPIN 代码: 3109-1583

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow

Svetlana S. Balyasnikova

N.N. Blokhin National Medical Research Center of Oncology

Email: Balyasnikova.Svetlana@gmail.com
ORCID iD: 0000-0002-9666-9301
SPIN 代码: 3987-2336

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow

Yana A. Dayneko

A.F. Tsyba Medical Radiological Research Center ― branch National Medical Research Radiological Center

Email: vorobeyana@gmail.com
ORCID iD: 0000-0002-4524-0839

MD, Cand. Sci. (Med.)

俄罗斯联邦, Obninsk

Darya V. Ryjkova

Almazov National Medical Research Centre

Email: d_ryjkova@mail.ru
ORCID iD: 0000-0002-7086-9153

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow

Malika M. Hodzhibekova

P.A. Herzen Moscow Research Oncological Institute ― branch National Medical Research Radiological Center

Email: malika_25@mail.ru
ORCID iD: 0000-0002-2172-5778
SPIN 代码: 3999-7304

MD, Dr. Sci. (Med.)

俄罗斯联邦, Moscow

Nataliya A. Rucheva

V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs

Email: rna1969@yandex.ru
ORCID iD: 0000-0002-8063-4462
SPIN 代码: 2196-8300

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow

Igor E. Turin

N.N. Blokhin National Medical Research Center of Oncology

Email: igortyurin@gmail.com
ORCID iD: 0000-0002-8587-4422
SPIN 代码: 6499-2398

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow

Sergey I. Achkasov

State Scientific Centre of Coloproctology

Email: achkasovy@mail.ru
ORCID iD: 0000-0001-9294-5447
SPIN 代码: 5467-1062

MD, Dr. Sci. (Med.), Professor, Corresponding Member of the Academy of Sciences

俄罗斯联邦, Moscow

Alexey A. Nevolskikh

A.F. Tsyba Medical Radiological Research Center ― branch National Medical Research Radiological Center

Email: alexey.nevol@gmail.com
ORCID iD: 0000-0001-5961-2958
SPIN 代码: 3787-6139

MD, Dr. Sci. (Med.)

俄罗斯联邦, Obninsk

Sergey S. Gordeev

N.N. Blokhin National Medical Research Center of Oncology

Email: ss.netoncology@gmail.com
ORCID iD: 0000-0002-9303-8379
SPIN 代码: 6577-5540

MD, Dr. Sci. (Med.)

俄罗斯联邦, Moscow

Inna V. Droshneva

P.A. Herzen Moscow Research Oncological Institute ― branch National Medical Research Radiological Center

编辑信件的主要联系方式.
Email: droshnevainna@mail.ru
SPIN 代码: 1908-2624

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow

参考

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2. 图1。T2-WI上的直肠MRI解剖图： a——矢状面：肛门边缘（括约肌间沟；虚线）；位于肛管内括约肌上缘水平的肛门与直肠交界处（角）（白色箭头）；位于骨盆内脏腹膜与直肠壁附着点下部的移行性腹膜皱襞（星号）；直肠腹膜部分（黑色箭头）； b——冠状面：1——肛管内括约肌；2——括约肌间隙；3——外括约肌深部；4——外括约肌浅部；5——外括约肌皮下部；6——耻骨直肠肌；7——提肛肌；c——轴状面：1——肠腔；2——粘膜；3——粘膜下层；4——肌肉层；5——直肠系膜纤维；6——直肠系膜筋膜。

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3. 图2。全直肠系膜切除术中的直肠环周切缘： a（示意图）——肿瘤壁外扩散（绿线）；直肠系膜筋膜（黄线）；环周切缘（红线）；肿瘤到直肠系膜筋膜的距离（黑色双箭头）；肿瘤到环周切缘的距离（红色双箭头）；b——直肠壶腹下部肿瘤冠状面上的T2-WI，伴有壁外血管侵犯和轴向T2-WI水平沉积；c——上部轴切片与累及直肠系膜筋膜（黑色箭头）和直肠系膜外淋巴 结（虚线箭头）的沉积水平相对应；下部轴切片与壁外血管侵犯水平相对应，壁外侵犯的深度——白色双箭头；肿瘤到提肛肌的距离——黑色双箭头。

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4. 图3。T2-WI上的肿瘤图像变体：a——息肉样/外生性肿瘤（箭头）；b——半圆形肿瘤（T），壁外血管侵犯（箭头）；c——黏液性肿瘤（箭头）。

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5. 图4。骨盆外侧淋巴结定位图（用颜色表示）：红色为髂外淋巴结，蓝色为闭孔淋巴结，绿色为髂内淋巴结。水平：a——近端；b——远端。НПА——髂外动脉；НПВ——髂外静脉；ВПВ——髂内静脉；ВПА——髂内动脉；Зап а/в/н——闭孔动脉/静脉/神经；ВЗМ——闭孔内肌。

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6. 图5。根据TRG标度在高分辨率T2-WI上的肿瘤退缩程度评估： TRG1：a——新辅助化疗前在假定性表盘12-2小时的肿瘤（箭头）；b——治疗后，肿瘤已被粘膜下层的线状纤维化区域取代；TRG2：c——化放疗前的直肠壶腹下部肿瘤（箭头）；d——治疗后，肿瘤被定义为厚纤维化区域（箭头），没有肿瘤组织的宏观MR征象；TRG3：e——化放疗前的直肠壶腹下部半圆形肿瘤（箭头）；f——治疗后，肿瘤呈混杂MR信号，以纤维化特征的低强度信号为主，并保留中等强度肿瘤MR信号的宏观区域（箭 头）；TRG4：g——化疗前的肿瘤（箭头）；h——治疗后（箭头），没有治疗反应迹象，保留肿瘤组织的MR信号。

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