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多机构研究结直肠癌肝转移的危险因素:与 CD10 表达的相关性。

Multi-institutional study of risk factors of liver metastasis from colorectal cancer: correlation with CD10 expression.

机构信息

Colorectal Surgery Division, National Cancer Center Hospital, 1-1 Tsukiji 5-chome, Chuo-ku, Tokyo 104-0045, Japan.

出版信息

Int J Colorectal Dis. 2010 Jun;25(6):681-6. doi: 10.1007/s00384-010-0913-x. Epub 2010 Mar 5.

Abstract

BACKGROUND

The risk factors for liver metastasis from colorectal cancer are still unclear. We therefore evaluated the relationships between various clinicopathological factors, including CD10 expression, liver metastasis, and survival, in patients with colorectal cancer.

METHODS

Clinicopathological data for 1,025 patients with stage II or III colorectal cancer who underwent curative surgery in four participating hospitals were collected and evaluated. Three pathologists examined focal dedifferentiation, venous invasion, and CD10 expression without knowledge of the clinical outcome.

RESULTS

Univariate analysis showed that pathological T (pT), pathological N (pN), venous invasion, focal dedifferentiation, and CD10 expression were significantly associated with liver metastasis. Multivariate analysis selected pT, pN, and CD10 expression as significant risk factors for liver metastasis. pT, pN and CD10 were also shown by univariate and multivariate analyses to be significantly associated with disease-free survival. The incidence of liver metastasis was 3% in pN0 patients with CD10-negative or pT2 or pT3 tumors and 28% in pN2 patients with CD10-positive or pT4 tumors.

CONCLUSIONS

CD10 expression is a significant risk factor for liver metastasis in patients with colorectal cancer and is correlated with prognosis. Patients with a high risk of liver metastasis can be selected on the basis of pT, pN, and CD10 expression.

摘要

背景

结直肠癌肝转移的危险因素仍不清楚。因此,我们评估了包括 CD10 表达在内的各种临床病理因素与结直肠癌肝转移和生存之间的关系。

方法

收集并评估了四家参与医院接受根治性手术的 1025 例 II 期或 III 期结直肠癌患者的临床病理数据。三位病理学家在不了解临床结果的情况下检查了局灶性去分化、静脉侵犯和 CD10 表达。

结果

单因素分析显示,病理 T(pT)、病理 N(pN)、静脉侵犯、局灶性去分化和 CD10 表达与肝转移显著相关。多因素分析选择 pT、pN 和 CD10 表达作为肝转移的显著危险因素。pT、pN 和 CD10 也通过单因素和多因素分析与无病生存显著相关。在 pN0 患者中,CD10 阴性或 pT2 或 pT3 肿瘤的肝转移发生率为 3%,而 pN2 患者中 CD10 阳性或 pT4 肿瘤的肝转移发生率为 28%。

结论

CD10 表达是结直肠癌患者肝转移的一个显著危险因素,与预后相关。可以根据 pT、pN 和 CD10 表达选择具有高肝转移风险的患者。

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