Glasgow University Department of Surgery, Glasgow, UK.
Future Oncol. 2011 Oct;7(10):1223-35. doi: 10.2217/fon.11.99.
Tumor necrosis has been proposed as a marker of poor prognosis in a variety of solid organ malignant tumor types. Despite this, its assessment has yet to be adopted into routine clinical practice and the mechanisms underpinning the relationships with cancer outcome are undetermined.
To examine the prognostic value of tumor necrosis in solid organ malignant disease and to summarize the known clinical, pathological and inflammatory associations.
A systematic review of data published from 1966-2011 was undertaken by two reviewers according to a predefined protocol. A total of 57 independent studies relating to renal (n = 23), breast (n = 13), lung (n = 7), colorectal (n = 5) and other solid tumors (n = 9) were included in the final review.
There is now a substantial body of evidence confirming the prognostic value of tumor necrosis in solid organ malignant disease. There are consistent associations between necrosis and the presence of other high-risk tumor characteristics but the survival impact appears to be independent of pathological stage. We propose that relationships with the host inflammatory response, both local and systemic, may explain the influence of tumor necrosis on cancer outcome.
在多种实体器官恶性肿瘤类型中，肿瘤坏死已被提出作为预后不良的标志物。尽管如此，其评估尚未被纳入常规临床实践，并且与癌症结局相关的机制尚不确定。
检查实体器官恶性疾病中肿瘤坏死的预后价值，并总结已知的临床、病理和炎症相关性。
两位评审员根据预设方案对 1966 年至 2011 年发表的数据进行了系统评价。最终综述共纳入了 57 项独立的研究，涉及肾脏（n = 23）、乳房（n = 13）、肺（n = 7）、结直肠（n = 5）和其他实体瘤（n = 9）。
现在有大量证据证实肿瘤坏死在实体器官恶性疾病中的预后价值。坏死与其他高危肿瘤特征的存在之间存在一致的关联，但生存影响似乎独立于病理分期。我们提出，与宿主炎症反应（局部和全身）的关系可能解释了肿瘤坏死对癌症结局的影响。
