IIB期结直肠癌的组织病理学风险分层

Histopathologic risk stratification of stage IIB colorectal cancer.

作者信息

Komori Koji, Kinoshita Takashi, Oshiro Taihei, Ito Seiji, Abe Tetsuya, Senda Yoshiki, Misawa Kazunari, Ito Yuichi, Uemura Norihisa, Natsume Seiji, Kawakami Jiro, Ouchi Akira, Tsutsuyama Masayuki, Hosoi Takahiro, Shigeyoshi Itaru, Akazawa Tomoyuk, Hayashi Daisuke, Tanaka Hideharu, Shimizu Yasuhiro

机构信息

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.

出版信息

Surg Today. 2017 Aug;47(8):934-939. doi: 10.1007/s00595-016-1456-8. Epub 2016 Dec 30.

DOI:10.1007/s00595-016-1456-8

PMID:28039532

Abstract

PURPOSE

To stratify stage IIB (pT4a PN0) colorectal cancer in terms of histopathologic findings.

METHODS

We reviewed the medical records of 80 patients who underwent surgery for stage IIB colorectal cancer. The disease-free survival (DFS) and overall survival (OS) rates were evaluated and correlated with the presence or absence of "Tumor Necrosis", "Crohn's-like lymphoid reaction", and "Perineural Invasion".

RESULTS

Patients with "Tumor Necrosis" had significantly lower DFS rates (p < 0.0001), those with "Crohn's-like lymphoid reaction" had significantly higher DFS rates (p = 0.037), and those with "Perineural Invasion" had significantly lower DFS rates (p < 0.0001). Patients with "Tumor Necrosis" had significantly lower OS rates (p = 0.016), those with "Crohn's-like lymphoid reaction" had significantly higher OS rates (p = 0.022), and those with "Perineural Invasion" had significantly lower OS rates (p = 0.003).

CONCLUSIONS

Since stage IIB colorectal cancers accompanied by the pathological findings of "Tumor Necrosis" and "Perineural Invasion", but with the absence of "Crohn's-like lymphoid reaction" carried a poor prognosis, the efficacy of adjuvant chemoradiation must be considered for these patients.

摘要

目的

根据组织病理学结果对IIB期（pT4a PN0）结直肠癌进行分层。

方法

我们回顾了80例接受IIB期结直肠癌手术患者的病历。评估无病生存期（DFS）和总生存期（OS）率，并将其与“肿瘤坏死”、“克罗恩样淋巴反应”和“神经周围侵犯”的有无相关联。

结果

有“肿瘤坏死”的患者DFS率显著较低（p < 0.0001），有“克罗恩样淋巴反应”的患者DFS率显著较高（p = 0.037），有“神经周围侵犯”的患者DFS率显著较低（p < 0.0001）。有“肿瘤坏死”的患者OS率显著较低（p = 0.016），有“克罗恩样淋巴反应”的患者OS率显著较高（p = 0.022），有“神经周围侵犯”的患者OS率显著较低（p = 0.003）。