Pathology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
Pathol Int. 2009 Dec;59(12):857-62. doi: 10.1111/j.1440-1827.2009.02464.x.
The purpose of the present study was to determine whether the amount and the location of residual tumor are associated with outcome in surgically treated rectal cancer patients who receive preoperative chemoradiation therapy. Forty-three rectal cancer patients who underwent sphincter-saving operations after preoperative chemoradiation therapy were enrolled in the study. The total area of residual tumors was measured using morphometry software, and then the area of the residual tumors located within and beyond the muscular layer was also determined. Associations between clinicopathological features were evaluated. The results showed that the total area of residual tumor and area of residual tumor within the muscular layer were associated with TNM stage, tumor regression, and microscopy features, but not with patient disease-free survival. The area of the residual tumor located beyond the muscular layer was significantly associated with pathological ypT, ypN stage, tumor downstaging, perineural invasion, and the depth of tumor invasion beyond the muscular layer (P < 0.05). Further, large residual tumor area beyond the muscular layer was associated with shorter disease-free survival (P < 0.05). Morphometry of residual tumor area beyond the muscular layer is a new pathological prognostic factor for rectal cancer patients receiving preoperative chemoradiation therapy.
本研究旨在确定接受术前放化疗的直肠癌患者手术后残留肿瘤的数量和位置是否与预后相关。本研究纳入了 43 例接受术前放化疗后保肛手术的直肠癌患者。使用形态计量学软件测量残余肿瘤的总面积，然后确定位于肌层内和肌层外的残余肿瘤的面积。评估了临床病理特征之间的关联。结果表明，残余肿瘤的总面积和位于肌层内的残余肿瘤面积与 TNM 分期、肿瘤消退和显微镜特征有关，但与患者无病生存无关。位于肌层外的残余肿瘤面积与病理ypT、ypN 分期、肿瘤降期、神经周围侵犯以及肿瘤侵犯肌层深度有关（P<0.05）。此外，肌层外残余肿瘤面积较大与无病生存时间缩短有关（P<0.05）。位于肌层外的残余肿瘤面积的形态计量学是接受术前放化疗的直肠癌患者的一个新的病理预后因素。
