Grabowski P, Schindler I, Anagnostopoulos I, Foss H D, Riecken E O, Mansmann U, Stein H, Berger G, Buhr H J, Scherübl H
Medizinische Klinik I, Universitätsklinikum Benjamin Franklin, FU Berlin, Germany.
Eur J Gastroenterol Hepatol. 2001 Apr;13(4):405-11. doi: 10.1097/00042737-200104000-00018.
To determine the prognostic relevance of neuroendocrine differentiation in colorectal cancer.
The survival of 116 patients with colorectal cancer of stages III (n = 59) and IV (n = 57) was correlated with the extent of neuroendocrine differentiation. Chromogranin A and synaptophysin were used as neuroendocrine markers. Based on the degree of immunoreactivity for these markers, tumours were classified as 0 (no expression of neuroendocrine markers), 1 (< 2% cells staining positive for neuroendocrine markers) and 2 (> 2% cells staining positive for neuroendocrine markers). Patients were followed up for more than 5 years or until death.
Seven of 59 (11.8%) stage III cancers and 13/57 (22.8%) stage IV cancers belonged to group 2. The 96 patients of groups 0 and 1 lived for 48.9 months, whereas the 20 patients of group 2 survived for only 18.6 months (Kaplan-Meier survival curves, P < 0.001). The difference was most striking in stage III disease with 79.4 months' survival for combined groups 0 and 1, and 38.9 months' survival for group 2 (P < 0.01). Using the multivariate Cox regression model, the presence of more than 2% of cells with neuroendocrine differentiation was found to be an independent prognostic parameter for stage III and IV disease. No correlation was observed between neuroendocrine differentiation and tumour location, grade, depth of invasion or stage.
Neuroendocrine differentiation is often seen in colorectal cancer. It is an independent prognostic factor in stage III-IV colorectal cancer.
确定神经内分泌分化在结直肠癌中的预后相关性。
116例III期（n = 59）和IV期（n = 57）结直肠癌患者的生存情况与神经内分泌分化程度相关。嗜铬粒蛋白A和突触素用作神经内分泌标志物。根据这些标志物的免疫反应程度，肿瘤被分类为0（无神经内分泌标志物表达）、1（<2%细胞神经内分泌标志物染色阳性）和2（>2%细胞神经内分泌标志物染色阳性）。对患者进行了超过5年的随访或直至死亡。
59例III期癌症中有7例（11.8%），57例IV期癌症中有13例（22.8%）属于2组。0组和1组的96例患者生存了48.9个月，而2组的20例患者仅存活了18.6个月（Kaplan-Meier生存曲线，P < 0.001）。在III期疾病中差异最为显著，0组和1组合并后的生存期为79.4个月，2组为38.9个月（P < 0.01）。使用多变量Cox回归模型，发现神经内分泌分化细胞超过2%的存在是III期和IV期疾病的独立预后参数。未观察到神经内分泌分化与肿瘤位置、分级、浸润深度或分期之间的相关性。
神经内分泌分化在结直肠癌中常见。它是III-IV期结直肠癌的独立预后因素。
