Preoperative staging of rectal cancer with MRI: correlation with pathologic staging

Introduction: An accurate preoperative rectal cancer staging is crucial to the correct management of the disease. Despite great controversy around this issue, pelvic magnetic resonance (RM) is said to be the imagiologic standard modality. This work aimed to evaluate magnetic resonance accuracy in preoperative rectal cancer staging comparing with the anatomopathological results. Methods: We calculated sensibility, specificity, positive (VP positive) and negative (VP negative) predictive values for each T and N. We evaluated the concordance between both methods of staging using the Cohen weighted K (Kw), and through ROC curves, we evaluated magnetic resonance accuracy in rectal cancer staging. Results: 41 patients met the inclusion criteria. We achieved an efficacy of 43.9% for T and 61% for N staging. The respective sensibility, specificity, positive and negative predictive values are 33.3%, 94.7%, 33.3% and 94.7% for T1; 62.5%, 32%, 37.0% and 57.1% for T2; 31.8%, 79%, 63.6% and 50% for T3 and 27.8%, 87%, 62.5% and 60.6% for N. We obtained a poor concordance for T and N staging and the anatomopathological results. The ROC curves indicated that magnetic resonance is ineffective in rectal cancer staging. Conclusion: Magnetic resonance has a moderate efficacy in rectal cancer staging and the major difficulty is in differentiating T2 and T3. (AU)

Introdução: Um estadiamento pré-operatório do Câncer do Reto (CR) é essencial na gestão da doença. Apesar de grande controvérsia, a ressonância magnética pélvica (RM) é apontada como modalidade imagiológica standard. Com este trabalho pretendeu-se avaliar a acuidade da RM no estadiamento do CR, comparando com os resultados anatomopatológicos da peça cirúrgica. Materiais e métodos: Calculou-se a sensibilidade, especificidade, valor preditivo positivo (VP positivo) e negativo (VP negativo) para T e N. Avaliou-se a concordância entre ambas as formas de estadiamento através do valor de K de Cohen ponderado (Kw) e, através de curvas ROC, avaliou-se a precisão do estadiamento por RM. Resultados: 41 doentes cumpriram os critérios de inclusão. Obteve-se uma eficácia de 43.9% para T e 61% para N. Verificou-se uma sensibilidade, especificidade, VP positivo e negativo, respectivamente, de 33.3%, 94.7%, 33.3% e 94.7% para T1, 62.5%, 32%, 37.0% e 57.1% para T2, 31.8%, 79%, 63.6% e 50% para T3, 27.8%, 87%, 62.5% e 60.6% para N. A concordância calculada foi pobre para T e N. As curvas ROC indicaram que o estadiamento do CR por RM foi ineficaz. Conclusão: A RM apresenta acuidade moderada no estadiamento do CR, onde a maior dificuldade está na distinção entre T2-T3. (AU)

Validación del índice de masa corporal en embarazadas con relación al nomograma de Rosso y Mardones La Paz-Bolivia / Validation of BMI in relation to pregnant Rosso and Mardones nomogram La Paz-Bolivia

Pregunta de investigación. ¿Cual sera la validez del índice de masa corporal en embarazadas con relación al nomograma de Rosso y Mardones en los hospitales materno infantil, de la mujer y boliviano holandés de la ciudad de La Paz de enero a febrero gestión 2002?. Objetivo general. Determinar la sensibilidad, especificidad, valores predictivos positivos y negativo, además de los likelihood ratio del índice de masa corporal en embarazadas con relación al nomograma de Pedro Rosso y Mardones en los hospitales materno infantil, de la mujer y boliviano holandés de enero a febrero gestíon 2002. Diseño de estudio en la investigación. Test diagnóstico. Lugar. Hospital Materno Infantil, Hospital de la Mujer de la ciudad de La Paz y Hospital Boliviano Holandés de la Ciudad de El Alto. Población. Embarazadas, desde la décima semana a la semana 40 de gestación que asistieron al control prenatal de rutina de los hospitales señalados anteriormente. Métodos. Se evaluó el estado nutricional de la embarazada utilizando el Indice de Masa Corporal IMC (prueba a validarse) y el Nomograma de Rosso y Mardones (Gold Estandar). Para los cálculos de sensibilidad, especificidad, valores predictivos positivos y valores predictivos negativos se utilizó el paquete estadístico EPIDATA y para los cálculos estadísticos el paquete estadístico STATA 6.0. Se realizó el análisis descriptivo utilizando medidas de tendencia central y de dispersión como Promedio, Desviación Estandar, verificando a través del cálculo del intervalo de confianza 95 por ciento, porcentajes y frecuencia para las variables cualitativas. Resultados. El presente estudio se realizó en 479 embarazadas que asistieron al control prenatal de rutina en los meses de enero y febrero del 2002...

What is the validity of the Body Mass Index in pregnant women in relation to the Normogram of Rosso and Mardones in the Hospitals "Materno Infantil" " de la Mujer", and "Boliviano Holandés" in La Paz, from January to February 2002 ? General Objective o determine sensibility, specificity, positive and negative predictive values, in addition to likelihood ratio and Body Mass Index in pregnant women in relation to the Normogram of Pedro Rosso and Mardones in the Hospitals "Materno Infantil", "de la Mujer", and Boliviano Holandés" from January to February 2002. Research Design Diagnostic test SITE"Hospital Materno Infantil", "Hospital de la Mujer", "Hospital Boliviano Holandés" in La Paz. SAMPLE The sample consisted of 479 pregnant women, from the 10th week of gestation to 40 weeks of gestational age who came for routine prenatal control to the above mentioned hospitals. Methods We assessed the nutritional status of the pregnant woman using the Body Mass Index (the test to be validated), and the Normogram of Rosso and Mardones (Gold Standard).For the calculation of sensibility, specificity, negative and positive predictive values, we used the statistic package EPIDATA, and for the statistic calculus the statistic package STATA 6.0.For the descriptive analysis we used measures of central tendency and of dispersion like Mean, Standard Deviation, verifying by means of calculating the Confidence Interval 95%, percentages and frequency for the qualitative values. In order to establish the relationship between both tests we used the tests of Correlation and Chi2 .Result The present study was carried out in 479 pregnant women who came to the routine prenatal control in January and February 2002 in the Hospitals "Materno Infantil", "Boliviano Holandés", and "Hospital de la Mujer".The nutritional diagnose of the preThe results of the...