Takeuchi Kunio, Kuwano Hiroyuki, Tsuzuki Yasushi, Ando Tetsu, Sekihara Masao, Hara Takashi, Asao Takayuki
Department of Surgery, Tone Chuo Hospital, Numata-city, Gunma, Japan.
Hepatogastroenterology. 2004 Nov-Dec;51(60):1698-702.
BACKGROUND/AIMS: The clinicopathological significance of poorly differentiated adenocarcinoma (Por) of the colorectum remains controversial. The purpose of this study was to investigate the clinicopathological characteristics of Por by comparison with well (Well) and moderately differentiated adenocarcinoma (Mod) of the colorectum and by subclassification of Por into three types according to the amount of fibrous stroma in tumor tissue.
Eleven patients with Por, 64 with Well and 254 with Mod were clinicopathologically compared.
Por was located predominantly in the right side of the colon. The maximal size of the tumors in Por (72.3+/-25.0 mm) was significantly larger than in Well (42.2+/-26.8 mm) and Mod (52.2+/-22.8 mm) (p=0.0009, 0.0047). The frequency of lymph node metastasis in Por was significantly higher than in Well (p=0.0009). The five-year survival rate for patients with Por was 45.5%, for Well was 71.4% and for Mod was 59.5% (NS). The medullary type of Por had a good prognosis.
Por proliferated and metastasized more rapidly than Well. The subclassification of Por according to the amount of fibrous stroma in tumor tissue could play an important role in the clinicopathological study of colorectal carcinoma.
背景/目的：结直肠低分化腺癌（Por）的临床病理意义仍存在争议。本研究的目的是通过与结直肠高分化（Well）和中分化腺癌（Mod）进行比较，并根据肿瘤组织中纤维基质的含量将Por分为三种类型，来研究Por的临床病理特征。
对11例Por患者、64例Well患者和254例Mod患者进行临床病理比较。
Por主要位于结肠右侧。Por肿瘤的最大尺寸（72.3±25.0mm）明显大于Well（42.2±26.8mm）和Mod（52.2±22.8mm）（p=0.0009，0.0047）。Por的淋巴结转移频率明显高于Well（p=0.0009）。Por患者的五年生存率为45.5%，Well患者为71.4%，Mod患者为59.5%（无显著性差异）。Por的髓样型预后良好。
Por比Well增殖和转移更快。根据肿瘤组织中纤维基质的含量对Por进行亚分类可能在结直肠癌的临床病理研究中发挥重要作用。
