Cantonal Institute for Pathology, Cantonal Hospital Liestal, Mühlemattstrasse 11, 4410 Liestal, Switzerland.
Int J Colorectal Dis. 2010 Jun;25(6):741-6. doi: 10.1007/s00384-010-0890-0. Epub 2010 Feb 9.
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.
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.
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.
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。
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。
我们的数据强调了需要使用标准化标准，包括弹性染色，以可靠地检测 CRC 中的血管侵犯。尽管如此，V1IM/V1EM 在 I 期和 II 期 CRC 中的预后影响可能不像以前预期的那样大。
