Lino-Silva Leonardo Saul, Salcedo-Hernández Rosa Angelica, Herrera-Gómez Angel, Padilla-Rosciano Alejandro, Ramírez-Jaramillo Manuel, Herrera-Goepfert Roberto E, Meneses-García Abelardo
Instituto Nacional de Cancerología, Mexico City, Mexico
Instituto Nacional de Cancerología, Mexico City, Mexico.
Int J Surg Pathol. 2015 Feb;23(1):13-9. doi: 10.1177/1066896914542125. Epub 2014 Jul 11.
Colorectal carcinoma is one of the most common cancers in the human body. Colorectal carcinoma is a heterogeneous disease with variegated morphological patterns; some have shown themselves to have prognostic value. The World Health Organization classification recognizes many histological variants associated with adverse prognostic factors, one is the cribriform colonic carcinoma (CCC). In this work, we analyzed 18 cases of CCC compared with 228 conventional adenocarcinomas of colon, with the hypotheses that CCC compared with non-CCC have worse prognosis and decreased overall survival. CCC represent 7.3% of all colonic adenocarcinomas in this series, it presents in a median age of 56.3 years, all cases are in clinical stage III and IV, all invade subserosal adipose tissues or serosa, 90% have >5 positive lymph nodes and 89% have lymphovascular invasion. These known adverse prognostic factors reflect a lower 5-year survival, stage by stage, than conventional intestinal-type adenocarcinoma (56.8% vs 83.3%, P = .035). Cribriform carcinoma is a morphologic pattern that is underrecognized; in this work, we demonstrate its association with low survival, extensive lymphovascular invasion, and extensive lymph node metastasis, strong indicators of aggressive disease. Their proper recognition is mandatory to increase the number of cases and series to support our findings and include it in the current classifications.
结直肠癌是人体最常见的癌症之一。结直肠癌是一种具有多种形态学模式的异质性疾病；其中一些已显示出具有预后价值。世界卫生组织分类认可许多与不良预后因素相关的组织学变异，其中之一是筛状结肠癌（CCC）。在本研究中，我们分析了18例CCC，并与228例结肠传统腺癌进行比较，假设CCC与非CCC相比预后更差且总生存期降低。在本系列中，CCC占所有结肠腺癌的7.3%，其发病年龄中位数为56.3岁，所有病例均处于临床III期和IV期，均侵犯浆膜下脂肪组织或浆膜，90%有5个以上阳性淋巴结，89%有淋巴管侵犯。这些已知的不良预后因素反映出，与传统肠型腺癌相比，各阶段的5年生存率更低（56.8%对83.3%，P = 0.035）。筛状癌是一种未被充分认识的形态学模式；在本研究中，我们证明了它与低生存率、广泛的淋巴管侵犯和广泛的淋巴结转移相关，这些都是侵袭性疾病的有力指标。必须正确识别它们，以增加病例数量和系列研究来支持我们的发现，并将其纳入当前分类中。
