结内窦窝隐匿性肿瘤细胞与Ⅱ期/Dukes’B 期结直肠癌的复发/转移。

Occult neoplastic cells in the lymph node sinuses and recurrence/metastasis of stage II/Dukes' B colorectal cancer.

机构信息

Department of Pathology, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan.

出版信息

Oncol Rep. 2011 Jan;25(1):69-73.

Abstract

Lymph nodes from patients with colorectal cancer were immunohistochemically stained for cytokeratin in order to investigate the relationship between the presence of occult neoplastic cells (ONCs) and recurrence/metastasis. A total of 78 patients with stage II/Dukes' B colorectal cancer were divided into two groups. The first group consisted of 18 patients who had developed recurrence/metastasis (recurrence group) and the other one of 60 patients who had survived without recurrence (non-recurrence group). The presence of ONCs was compared between the two groups with respect to i) single cells (≥3 floating ONCs), ii) clusters of cells (≥1 floating aggregates of 2-20 ONCs), and iii) single cells + clusters. When single cells were detected, the sensitivity for recurrence was 55.6% (10/18), the positive predictive value (PPV) was 30.3% (10/33), the specificity was 61.7% (37/60, p=0.195), and the negative predictive value (NPV) was 82.2%(37/45). For the clusters, the sensitivity was 55.6% (10/18), PPV was 37% (10/27), specificity was 71.7% (43/60, p=0.033), and NPV was 84.3% (43/51). With single cells + clusters, the values were 55.6% (10/18), 43.5% (10/23), 78.3% (47/60, p=0.006), and 85.5% (47/55), respectively. These results suggest that the detection of single cells + clusters has a high specificity and NPV, and indicates a low risk of recurrence/metastasis in patients with stage II colorectal cancer.

摘要

为了研究隐匿性肿瘤细胞（ONC）的存在与复发/转移之间的关系，对来自结直肠癌患者的淋巴结进行了细胞角蛋白免疫组织化学染色。共有 78 例 II 期/ Dukes'B 结直肠癌患者分为两组。第一组包括 18 例出现复发/转移的患者（复发组），另一组包括 60 例无复发的患者（无复发组）。比较两组之间 ONC 的存在情况，包括：i）单个细胞（≥3 个漂浮 ONC）、ii）细胞簇（≥2-20 个 ONC 的 1 个漂浮聚集物）和 iii）单个细胞+细胞簇。当检测到单个细胞时，复发的敏感性为 55.6%（18/33），阳性预测值（PPV）为 30.3%（10/33），特异性为 61.7%（60/37，p=0.195），阴性预测值（NPV）为 82.2%（37/45）。对于细胞簇，敏感性为 55.6%（18/27），PPV 为 37%（10/27），特异性为 71.7%（60/43，p=0.033），NPV 为 84.3%（43/51）。对于单个细胞+细胞簇，敏感性为 55.6%（18/23），PPV 为 43.5%（10/23），特异性为 78.3%（60/47，p=0.006），NPV 为 85.5%（47/55）。这些结果表明，单个细胞+细胞簇的检测具有高特异性和 NPV，并提示 II 期结直肠癌患者复发/转移的风险较低。