弹性染色在检测淋巴结阴性结直肠癌患者静脉侵犯中的预后价值。

Impact of using elastic stains for detection of venous invasion in the prognosis of patients with lymph node negative colorectal cancer.

机构信息

Cantonal Institute for Pathology, Cantonal Hospital Liestal, Mühlemattstrasse 11, 4410 Liestal, Switzerland.

出版信息

Int J Colorectal Dis. 2010 Jun;25(6):741-6. doi: 10.1007/s00384-010-0890-0. Epub 2010 Feb 9.

DOI:10.1007/s00384-010-0890-0

PMID:20143235

Abstract

PURPOSE AND METHODS

Patients with nodal negative colorectal cancer (CRC) suffer recurrent or metastatic disease in 40% of cases after surgical resection. To investigate a potential prognostic impact of vascular tumor infiltration, we retrospectively analyzed 185 nodal negative stage I and II CRC specimens for the presence of intra- and/or extramural venous invasion (V1IM/V1EM) using elastic stains of all tumor sections and correlated our findings with the clinical follow-up.

RESULTS

Venous invasion was observed in 43 (23.2%) patients by elastic stains compared with six (3.2%) using HE only (p < 0.05). Venous invasion was more common in stage II than in stage I tumors (28.1% versus 5.1%; p < 0.05). However, survival analyses showed no significant differences in 5-year survival rates comparing patients with and without venous invasion (68% and 71%, p = 0.543) or patients with V1IM and V1EM (62% vs. 74%, p = 0.473), respectively.

CONCLUSIONS

Our data emphasize the need for standardized criteria, including elastic stains, to reliably detect vascular invasion in CRC. Doing so, however, the prognostic impact of venous invasion in stage I and II CRC may be lower as previously anticipated.

摘要

目的和方法

在接受手术切除的结直肠癌（CRC）患者中，淋巴结阴性患者有 40%在术后复发或转移。为了研究血管肿瘤浸润的潜在预后影响，我们使用所有肿瘤切片的弹力染色，回顾性分析了 185 例淋巴结阴性 I 期和 II 期 CRC 标本，以确定是否存在血管壁内和/或血管外侵犯（V1IM/V1EM），并将我们的发现与临床随访相关联。

结果

与仅使用 HE 染色发现的 6 例（3.2%）相比，弹性染色发现 43 例（23.2%）存在静脉侵犯（p<0.05）。V1IM/V1EM 在 II 期肿瘤中比在 I 期肿瘤中更常见（28.1%比 5.1%；p<0.05）。然而，生存分析显示，比较存在和不存在静脉侵犯的患者（5 年生存率分别为 68%和 71%，p=0.543）或 V1IM 和 V1EM 患者（5 年生存率分别为 62%和 74%，p=0.473）之间的 5 年生存率无显著差异。