新辅助免疫疗法对于患有微卫星不稳定性/错配修复缺陷（MSI/dMMR）的局限性结肠癌（CC）患者来说是一种有前途的策略。本研究的目的是评估术前计算机断层扫描 (CT) 扫描评估的临床 cTN 分期与 MSI/dMMR CC 的 pTN 分期之间的一致性。2013 年至 2022 年间连续诊断为局部 MSI/dMMR CC 并接受前期手术治疗的患者两个法国中心都有资格。两名对病理结果不知情的独立放射科医生审查了所有术前 CT 扫描并评估了 cTN 分期，第三名放射科医生审查了不一致的病例。计算了 pT4 和 pN（N = N1 或 N2）的放射学预测诊断准确性。纳入了 113 名患者（右侧 CC = 79%）。 pT4 的 CT 扫描诊断性能灵敏度 (Se) = 33.3%；特异性 (Sp) = 94.0%；阳性预测值 (PPV) = 66.7%；阴性预测值 (NPV) = 79.6%，pN 为 Se = 70.3%； Sp = 59.2%； PPV = 45.6%；净现值 = 80.4%。当 pT-pN 组合时，37.5% 被鉴定为 cT4 和/或 cN 的肿瘤实际上是 pT1-3 和 pN0，而 23.1% 的 pT4 和 pN 群体在放射学上并未被鉴定为这样。 术前 CT 扫描预测的能力pT 和 pN 阶段仅限于局部 MSI/dMMR CC。需要重新评估该人群中新辅助治疗策略的获益-风险平衡。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Neoadjuvant immunotherapy emerges as a promising strategy for patients with localized colon cancer (CC) harboring microsatellite instability/mismatch repair deficiency (MSI/dMMR). The aim of this study is to evaluate the concordance between clinical cTN stage assessed by preoperative computed tomography (CT) scan and pTN stage of MSI/dMMR CC.Consecutive patients diagnosed for localized MSI/dMMR CC and treated with upfront surgery between 2013 and 2022 in two French centers were eligible. Two independent radiologists, blinded to pathological findings, reviewed all preoperative CT scans and assessed cTN stage, with a third radiologist reviewing discordant cases. Radiological predictive diagnostic accuracy for pT4 and pN+ (N+ = N1 or N2) were calculated.One hundred and thirteen patients were included (right CCs = 79%). CT scan diagnostic performances for pT4 were sensitivity (Se) = 33.3%; specificity (Sp) = 94.0%; positive predictive value (PPV) = 66.7%; and negative predictive value (NPV) = 79.6% and for pN+ were Se = 70.3%; Sp = 59.2%; PPV = 45.6%; and NPV = 80.4%. When pT-pN were combined, 37.5% of tumors identified as cT4 and/or cN+ were actually pT1-3 and pN0, and 23.1% of the pT4 and pN+ population was not identified as such radiologically.The ability of preoperative CT scan to predict pT and pN stages is limited for localized MSI/dMMR CCs. Reassessing neoadjuvant strategies' benefit-risk balance in this population is needed.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.