Elbarmelgi Mohamed Yehia, Farag Ahmed, Azim Hamdy A, Abozeid Ahmed Abdelaziz, Mashour Abdrabou N, Mikhail Hany M S
General Surgery Department, Cairo University, Cairo, Egypt.
Medical Oncology Department, Cairo University, Cairo, Egypt.
Arab J Gastroenterol. 2015 Sep-Dec;16(3-4):113-5. doi: 10.1016/j.ajg.2015.09.010. Epub 2015 Oct 30.
The two very important prognostic risk factors of colorectal cancer are circumferential tumour margin (CTM) involvement and preoperative levels of carcinoembryonic antigen (CEA). The aim of this study is to monitor the frequency of reporting of the CTM in the postoperative pathology reports after colorectal cancer resection in addition to monitoring the frequency of reporting of preoperative levels of CEA and exploring the possibility of improving the frequency of reporting of both.
Reports of the CTM and preoperative level of CEA were found in 730 (664 retrospective and 66 prospective) patients with colorectal cancer. The possibility of improving the incidence of reporting was estimated by comparing the reporting frequency of both (retrospective and prospective) groups.
The percentage of reporting the involvement of the CTM was 46.08% and 81.81% for the retrospective group and the prospective group, respectively. The percentage of reporting the preoperative CEA levels was 40.9% and 68.7% for the retrospective and the prospective groups, respectively. There was a statistically significant difference in reporting both CTMs and the preoperative level of CEA between retrospective and prospective groups to the side of prospective group in which the p-value was <0.0001 for both groups.
There was inadequate reporting of both the CTM involvement and preoperative levels of CEA in the retrospective patients with statistically significant improvement of this reporting in patients in the prospective group. This may point to the unawareness of the importance of both in the prognosis of colorectal cancer, which may be because both are not involved in the widely used tumour, node, metastasis (TNM) staging system.
结直肠癌两个非常重要的预后风险因素是环周切缘(CTM)受累情况和术前癌胚抗原(CEA)水平。本研究的目的是监测结直肠癌切除术后病理报告中环周切缘的报告频率,同时监测术前CEA水平的报告频率,并探索提高两者报告频率的可能性。
在730例(664例回顾性研究和66例前瞻性研究)结直肠癌患者中发现了环周切缘和术前CEA水平的报告。通过比较两组(回顾性和前瞻性)的报告频率来评估提高报告发生率的可能性。
回顾性组和前瞻性组中环周切缘受累情况的报告率分别为46.08%和81.81%。回顾性组和前瞻性组术前CEA水平的报告率分别为40.9%和68.7%。回顾性组和前瞻性组在环周切缘和术前CEA水平报告方面存在统计学显著差异,以前瞻性组为优,两组的p值均<0.0001。
回顾性研究的患者中环周切缘受累情况和术前CEA水平的报告均不足,前瞻性组患者的报告有统计学显著改善。这可能表明对两者在结直肠癌预后中的重要性认识不足,这可能是因为两者均未纳入广泛使用的肿瘤、淋巴结、转移(TNM)分期系统。