Kawahira Hiroshi, Hasebe Takahiro, Kinoshita Taira, Sasaki Satoshi, Konishi Masaru, Nakagori Toshio, Inoue Kazuto, Oda Tatsuya, Takahashi Shin-ichirou, Ochiai Takenori, Ochiai Atsushi
Pathology Division, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
Jpn J Cancer Res. 2002 Oct;93(10):1138-44. doi: 10.1111/j.1349-7006.2002.tb01216.x.
We have sometimes encountered invasive ductal carcinomas (IDCs) of the pancreas containing intraductal carcinoma components in the intra- and / or extra-tumor area. The purpose of this study was to investigate whether intraductal carcinoma components would be useful for predicting the outcome of IDC patients. Forty-seven surgically treated IDCs were examined, and all histological tumor sections were stained with Elastica to accurately confirm intraductal carcinoma components. Well-known clinicopathological parameters that exhibited a significant correlation in the univariate analyses for predicting disease-free survival (DFS) and overall survival (OS) were entered into the Cox proportional hazard multivariate analysis. Since the lowest P-value predicting DFS or OS periods was observed in IDCs with more than 10% intraductal carcinoma components and those with 10% or less intraductal carcinoma components (P = 0.028 and P = 0.019), we established the cutoff value of intraductal carcinoma components at 10%. In the multivariate analyses for DFS and OS, the presence of more than 10% intraductal carcinoma components showed a marginally significant increase in the hazard rate (HR) of tumor recurrence (P = 0.067) and significantly increased the HR of mortality (P = 0.040). The present study demonstrated that IDCs with more than 10% intraductal carcinoma components were associated with a significantly better patient outcome than those with 10% or less intraductal carcinoma components.
我们有时会遇到胰腺浸润性导管癌（IDC），其在肿瘤内和/或肿瘤外区域含有导管内癌成分。本研究的目的是调查导管内癌成分是否有助于预测IDC患者的预后。对47例接受手术治疗的IDC进行了检查，所有组织学肿瘤切片均用弹性蛋白染色，以准确确认导管内癌成分。将在单因素分析中与预测无病生存期（DFS）和总生存期（OS）有显著相关性的著名临床病理参数纳入Cox比例风险多因素分析。由于在导管内癌成分超过10%的IDC和导管内癌成分10%及以下的IDC中观察到预测DFS或OS期的最低P值（P = 0.028和P = 0.019），我们将导管内癌成分的临界值设定为10%。在DFS和OS的多因素分析中，导管内癌成分超过10%显示肿瘤复发风险率（HR）略有显著增加（P = 0.067），并显著增加死亡HR（P = 0.040）。本研究表明，导管内癌成分超过10%的IDC患者预后明显优于导管内癌成分10%及以下的患者。
